Is It Safe to Take Fosamax to Treat Osteoporosis?

If you have osteoporosis (weak, brittle bones), then you may have heard some negative stories about the osteoporosis medication Fosamax. Maybe, for instance, you heard that it doesn't build quality bone, that there is a risk of jaw demineralization, and that it's more harmful to take it than not.

It's a controversial topic, so read on to learn more about what scientists know so far about the drug and its side effects.

osteoporosis graphic
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What Is Fosamax?

Along with Actonel (risedronate) and Boniva (ibandronate), Fosamax (alendronate) belongs to a class of medications that are called bisphosphonates. They are the most commonly prescribed medications for the prevention and treatment of osteoporosis. These medications work by preventing the breakdown of bones and increasing bone density. They also decrease the risk of spine and hip fractures.

Health Risks

The health risks of using Fosamax for a long period of time are still not completely clear. There have been reports that some people who take Fosamax have developed a serious condition called osteonecrosis of the jaw, a condition in which bone tissue in the jaw dies, causing pain and the possible collapse of the jaw bone.

When reports first started coming in, it created a lot of buzz on the Internet and it does sound scary. However, the condition is uncommon overall. The risk is far more people with a type of cancer that's related to the bone who have received Fosamax intravenously (through a vein.) Some healthcare providers are concerned that over time Fosamax could make bones even more brittle, but this has not been proven.

In short, it is not yet known whether it's advisable to get off the drug for good or take periodic breaks from the medication. Since the drug has a long half-life, the effects of the drug can last in your body for a long time after you stop taking it.

Future research will hopefully help medical professionals sort out the answers. In the meantime, it is important to discuss all the pros and cons of Fosamax with your healthcare provider to figure out what's best for you.

How to Proceed

Making complicated health care decisions that may affect your well-being isn't easy, so take the following steps to help educate and protect yourself.

  • Read up on osteoporosis. Learn as much as you can about the condition. The National Osteoporosis Foundation provides excellent information for consumers about the prevention and treatment of osteoporosis, including safety tips on how to prevent fractures.
  • Consider supplements. It is important that you get sufficient calcium and vitamin D in addition to any medication that you take. Ask your healthcare provider whether taking supplements or adjusting your diet (or both) would be beneficial.
  • Learn about other treatment options. Find out more about other treatment options besides the class of drugs that includes Fosamax. You should discuss this with your primary care healthcare provider.
  • Know Fosamax's side effects. If your healthcare provider advises you to stay on Fosamax, make sure that you learn about the medication’s side effects. Although the chances of developing any problems with your jaw are small, you should be aware of this potential complication and immediately let your healthcare provider know if you have any swelling or pain in your jaw.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Abrahamsen B, Eiken P, Prieto-Alhambra D, Eastell R. Risk of hip, subtrochanteric, and femoral shaft fractures among mid and long term users of alendronate: nationwide cohort and nested case-control studyBMJ. 2016;353:i3365. doi:10.1136/bmj.i3365

  2. Heng C, Badner VM, Vakkas TG, Johnson R, Yeo Y. Bisphosphonate-related osteonecrosis of the jaw in patients with osteoporosisAm Fam Physician. 2012;85(12):1134–1141.

  3. Harvard Medical School: Harvard Health Publishing. By the way, doctor: Does Fosamax damage the jawbone?

  4. Prescribers' Digital Reference. Alendronate sodium - drug summary.

Additional Reading
  • National Institutes of Health: Osteoporosis and Related Bone Diseases National Resource Center. Osteoporosis Overview.

By Michael Bihari, MD
Michael Bihari, MD, is a board-certified pediatrician, health educator, and medical writer, and president emeritus of the Community Health Center of Cape Cod.