How Bisphosphonates Work

Recently, a class of drugs called bisphosphonates (including Fosamax) has come under attack as being linked to bone density problems, cancer, and heart disease, which has led to a number of Fosamax lawsuits. With millions of people taking Merck & Co. medication Fosamax and other bisphosphonate drugs, doctors are taking these allegations very seriously. As a patient, it is important to understand how bisphosphonates work, when and how you should take them, and why they could pose a threat to your health.

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Bisphosphonate drugs are most commonly used to prevent and treat osteoporosis in women over the age of 40. However, these drugs also can treat other bone disease that lead to bone fragility, such as Paget's disease, bone metastsis, and multiple myeloma. Although older women make up the largest group, any gender and age group can use bisphosphonates.

The first bisphosphonates were researched to treat bone disease in the 1960s, but only in the past two decades have these drugs really grown in popularity. Bisphosphonates come in both oral and injection forms, though the vast majority of patients use oral bisphosphonates. Alendronate and risedronate are the most-used bisphosphonates for treating bone diseases, and specifically alendronate, sold under the brand name Fosamax, has been studied due to potential serious side effects.

Fosamax and other bisphosphonates work by stopping the break down of bones. Every person has osteoclast cells in the body. Found in the bones, these cells are responsible for removing bone tissue (bone resorption), which allows the bone to grow strong as other cells rebuild the bone. With osteoporosis and other bone disease, there is an imbalance of bone resorption to new bone formation. Either the bone is not making new cells fast enough of the osteoclast cells are working too much. No matter what the case, by inhibiting the osteoclast cells, the bone density can return to normal.

This is just what Fosamax and other bisphosphonate drugs do. When introduced to the body, they are "eaten" by the osteoclast cells. Fosamax and most other bisphosphonates on the market (Boniva, Actonel, Zometa, etc.) are nitrogenous-containing bisphosphonates. What does that mean? Well, when a osteoclast cell "eats" a nitrogenous-containing bisphosphonate, it changes the cell's metabolism. Basically, it makes the cells work more slowly or die completely.

The result is an overall ability for the cells that are rebuilding your bones to catch up. Bone density improves, and you are less likely to break a bone during a fall or other accident. The problem with bisphosphonate drugs, however, is that sometimes they work too well. If too many osteoclasts die or they begin to work too slow, the bones could be too dense. When that happens, there isn't room for the inner space in the bone, called the bone marrow. The marrow is responsible for keeping the bone alive, so if there isn't enough marrow, the bone dies and cannot grow or heal once broken. Immobility and pain could also be problems. This condition is known as osteonecrosis and is especially common in the jaw.

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Due to these risks, some patients have stopped using Fosamax and other bisphosphonates. Patients with serious medical problems have even been getting involved with Fosamax lawsuits against drug manufacturer Merck. If you believe that you've been injured due to using Fosamax, contact a lawyer right away to learn about your rights.

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