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Serious Side Effects of Fosamax: Osteonecrosis and Jaw Bone Death

Fosamax And Other Bisphosphonate Drugs Cause "Bisphossy Jaw" In Some Patients

In 2004 Salvatore Ruggiero, MD, Chief of Oral and Maxillofacial Surgery at Long Island Jewis Medical Center and co-author of a report in the Journal of Oral and Maxillofacial Surgery, wrote about 63 patients who had osteonecrosis — or bone death — of the jaw. This article included reports about six patients who had taken Fosamax, and a seventh patient had taken Actonel, another oral bisphosphonate (pronounced bis-FOS-fo-nate) used for the prevention of osteoporosis.

Because Fosamax (alendronate; Merck & Co.), Actonel (risedronate; Proctor & Gamble Pharmaceuticals), and other bisphosphonates remain in the bone for an extended period, Dr. Ruggiero speculates that their long-term use could negatively affect the delicate balance in the jaw which exists normally between those cells that put calcium in bone and those cells that take calcium away, and thereby cause osteonecrosis of the jaw (sometimes referred to as "ONJ"). Some dentists and doctors have started to call this increasingly prevalent problem "bisphossy jaw".

Regardless of whether Dr. Ruggerio is correct as to how Actonel and Fosamax can cause osteonecrosis of the jaw, the FDA has concluded that the package insert, or label, all bisphosphonate drugs should mention osteonecrosis of the jaw as an assoicated side effect.

Because Fosamax and the other oral bisphosphonates stay in the bone for many years, a person can develop osteonecrosis, or ONJ, years after they have stopped using the drug.

The most common symptoms of osteonecrosis of the jaw are: pain; swelling and gum infections; loosening teeth; poor healing of gums after dental work; and, numbness or heavy feeling in jaw.

Based on allegations that Merck failed to warn about this serious side effect, some people who developed ostenecrosis of the jaw after taking Fosamax have filed personal injury lawsuits against the drug company.

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  • Reports of serious drug side effects should be made to the US FDA MedWatch program.
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