Dr. Paul Donohue: Your health

When is it OK to stop Fosamax?

Dear Dr. Donohue: I am very worried about being taken off Fosamax. I have osteoporosis and have taken Fosamax for 11 years. My doctor said I don't need to take it any longer because my system has enough of it. I am 79. Would you give me your opinion?

J.G.

Dear J.G.: Osteoporosis is a major health problem and a major cause of disability and medical expense.

Bisphosphonates are the class of drugs most often chosen to slow down osteoporosis. Fosamax (alendronate) is an often-prescribed bisphosphonate. It stops the daily breakdown of bone, and thereby strengthens bone. This action prevents bones from becoming fragile and easily broken.

One approach to treatment is to suggest to patients that they take a drug holiday after five to seven years of use. This suggestion is made to patients who have a "low fracture risk."

Fosamax and other bisphosphonates stay in bone for years and years, so you are still getting medicine after you have stopped taking it. When medicine is stopped, doctors follow their patients with scheduled bone mineral density tests.

A reason for concern is that bisphosphonates have side effects. One of them is osteonecrosis of the jaw. Osteonecrosis is death of a section of the jawbone, a consequence that's hard to treat and difficult to have.

People older than 50 need vitamin D (up to 1,000 IU a day) and calcium (up to 1,200 mg a day) for osteoporosis prevention. Daily exercise is also essential. Walking is appropriate.

Your health Write to Dr. Paul Donohue at P.O. Box 536475, Orlando, FL 32853-6475.