3 RARE FOSAMAX SIDE EFFECTS WOMEN OVER 50 SHOULD NEVER IGNORE

We eat healthy and exercise as regularly as we can to stay strong and ward off osteoporosis-but should the prescription drug Fosamax be part of our bone-boosting arsenal? Keep reading for a top physician's take on the potential side effects of this popular oral medication, the benefits Fosamax can offer and other therapies you might consider to fortify your bones for years to come.

What is Fosamax?

Fosamax, taken orally once a week, is a member of the bisphosphonate family of medications that treats osteoporosis by inhibiting the breakdown of bone, says Jocelyn Wittstein, MD, board-certified orthopedic surgeon and associate professor of orthopaedic surgery at Duke University School of Medicine.

It's typically prescribed for menopausal women who have osteoporosis, or weak and brittle bones. (It may also be used to treat osteoporosis in men.) The oral tablets are often taken in the morning on an empty stomach with a full glass of plain water, at least 30 minutes before eating or drinking anything else.

7 risk factors of osteoporosis

We know you've heard this before, but it bears repeating: Menopause increases the likelihood of developing osteoporosis due to declining levels of the sex hormone estrogen, which stimulates bone growth and curbs bone resorption. "That's why 75 percent of hip fractures occur in women," notes Dr. Wittstein, who adds a few other risk factors:

• Having a low body weight
• Being Caucasian
• Smoking (discover the best ways to quit smoking)
• Long-term use of heartburn medications, as they can interfere with calcium and vitamin absorption
• A history of low physical activity, especially impact or strength training
• Regular alcohol consumption
• Long-term use of prednisone

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3 rare Fosamax side effects

It must be said that Fosamax is highly effective at treating osteoporosis, reducing the risk of hip fractures by about 40 percent and vertebral fractures by almost 50 percent in post-menopausal women. And while the medication's side effects are rare, notes Dr. Wittstein, it always helps to be aware of them:

Heartburn

"[Fosamax] can cause some esophageal irritation and heartburn, and some people don't tolerate it that well," says Dr. Wittstein. If this is the case for you, she suggests an alternative osteoporosis therapy: a once-a-year intravenous infusion called Reclast.

"Because there is no heartburn side effect and the medication is given just once a year, there's typically a higher compliance rate," she says. And the benefits of the infusion are "huge," reducing the risk of vertebral fractures by 70 percent and hip fractures by 40 percent.

Osteonecrosis of the jaw (ONJ)

Given that "osteo" means bone and "necrosis" means death, it's safe to say this is a very scary Fosamax side effect that can cause pain and expose bone in the jaw. Fortunately, it's extremely rare, occurring in about 1 out of 100,000 people, reveals Dr. Wittstein.

It's also important to note that this side effect is seen more often with IV osteoporosis treatment, like Reclast, than with the Fosamax pill. "Most cases of ONJ have occurred in patients receiving IV infusions for [bone-related complications] from cancer, often at higher doses than the standard osteoporosis treatment," she points out. "So, the risk is likely different in this population."

Atypical hip fractures

While most hip fractures occur in the femoral neck, the upper part of the thigh bone, a rare but potential complication of Fosamax is an increased risk of an atypical hip fracture lower in the thigh bone, says Dr. Wittstein.

"It's thought that some of the bone that is built while taking Fosamax isn't totally normal in structure, so that in some cases, it fractures in an atypical way." Still, she points out that only about five percent of hip fractures are atypical.

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The bottom line on taking Fosamax for osteoporosis

Although women are advised to get a dual-energy X-ray absorptiometry (DEXA) scan to measure bone density at age 65, Dr. Wittstein recommends having one closer to the onset of menopause. That's in large part to help you determine if hormone replacement therapy (HRT)- a powerful prophylactic against osteoporosis-may be right for you.

"HRT that included estrogen reduces the likelihood of hip fracture by almost 30 percent and spinal fractures by 40 percent," she reveals. "Fosamax and similar medications are excellent treatments if you already have osteoporosis-but in a perfect world, women wouldn't need them because we'd be more proactive, using HRT when possible, eating a nutrient-dense diet rich in calcium, magnesium and vitamins D and K and doing regular weight-bearing exercise."

More stories on bone health:

Sneaky Osteoporosis Symptoms That Can Signal Bone Loss in Women Over 50

The Best Foods, Drinks and Exercises to Prevent Osteoporosis-No Meds Needed

Acting Like a Flamingo Strengthens Bones + More MD-Backed Ways to Ward Off Osteoporosis

This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan.

2025-12-04T09:06:18Z