A recent FDA article describes severe pain ociated with two bisphosphonate drugs: Fosamax (alendronate sodium) and Actonel (risedronate sodium).

The article, which was published in the Archives of Internal Medicine, describes over a hundred reports received by the FDA of severe bone, joint and muscle pain in patients being treated with Fosamax for osteoporosis. Many patients were unable to walk, climb stairs, or perform usual activities, and some of them became bedridden. Many of them had numerous diagnostic tests with mostly normal findings.

A majority of the patients experienced relief from pain after the drug was discontinued. This improvement was gradual in most of the patients, although some did show immediate improvement.

The article also notes that the FDA has received similar reports for Actonel, another bisphosphonate drug, and this suggests a possible class effect for these drugs.

The article says that pain in patients treated with bisphosphonates is likely to be underreported because of its subjective nature and because physicians may attribute the pain to the osteoporosis itself. It concludes that patients should be instructed to report severe bone, joint, or muscle pain that starts shortly after beginning bisphosphonate therapy, and that physicians should consider discontinuing the drug if that happens.

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