What's your experience with Fosamax?

meownsmile, BSN, RN · Oct 16, 2004

Nothin like waking a patient at 6 or 7AM giving them a pill and telling them they have to stay in a sitting position for 30 min.

Nurse Ratched, RN · Oct 16, 2004

No horror stories specifically about the med - only know that it is often not given correctly. Needs to be on an empty stomach with the aforementioned 1/2 hour upright afterward. I often see it on the med sheet with all the other a.m. meds and no mention of the upright part. I always change the time and write the notation in comments on the med sheet. It should come from pharmacy with those specific directions.

Antikigirl, ASN, RN · Oct 16, 2004

Oh I so agree! I have to hand write all of that info on a MAR for my clients..and I will tell you there are very little elderly women not on it! My hand is numb after doing a service area!

I have had a few minor and one major GI bleed dx'd in the hospital and patients taken off it quickly! I don't know if it was the cause, but I know that med didn't help! It is also amazing that I see clients taken off ASA r/t GI bleed hx or dx...but the fosomax is overlooked...I have faxed many a doc about that...and they d/c it every time!

Yeah..I watch that one for GI probelmatic folks, and also for people that can NOT sit up for 30 minutes, or confused clients that will not remember if they have an empty stomach! You have to watch for all the underlying issues that would make taking this med the right way a probelm .

LydiaGreen · Oct 16, 2004

Patient admitted with a diagnosis of chemical burn to the esophagus - caused by Fosamax and her not following the directions at home (on the box, in the package insert and reinforced by BOTH her doctor and her pharmacist - she figured it was "just a pill, not a bullet" and that everyone was being overly cautious. Exceedingly painful experience for her and a glaring caution to the nurses of how NOT to administer fosamax.

VickyRN, MSN, DNP, RN · Oct 16, 2004

No personal experience, but please refer to this thread:

https://allnurses.com/forums/showthread.php?t=62939&highlight=fosamax

In this thread, I contributed some very relevant information concerning fosamax.

I would not personally recommend nor take this drug.

PHTLS · Oct 17, 2004

Thanks for the reply fellow nurses ;-)

Sheri257 · Oct 17, 2004

No personal experience, but please refer to this thread:
https://allnurses.com/forums/showthread.php?t=62939&highlight=fosamax
In this thread, I contributed some very relevant information concerning fosamax.
I would not personally recommend nor take this drug.

So what would you recommend?

I'm confused with all of these reports about heart disease and cancer risk with HRT.

:confused:

oramar · Oct 17, 2004

I saw many admissions caused by the once a day drug. Since most my patients have been switched to once a week drug there is big improvement. No admissions in quite a while with the kind of bleeding that comes with the irritations caused by this drug.

allele, LPN · Oct 17, 2004

Among everything else, it's supposed to be given with a FULL eight ounces of water--and it can be water only to ensure the pill doesn't start to dissolve on the way down the esophagus--and should never be crushed. When I worked rehab the docs would frequently overlook the drug if the patient took meds via G tube or if they needed they're pills crushed. We would call and get the patient switched to myocalcin. I'm glad they came up with the once a week pill, it's got to be easier on the patients!! We can never manage to get it to the patient on the right day though! :rolleyes:

jnette, ASN, EMT-I · Oct 17, 2004

No personal experience, but please refer to this thread:
https://allnurses.com/forums/showthread.php?t=62939&highlight=fosamax
In this thread, I contributed some very relevant information concerning fosamax.
I would not personally recommend nor take this drug.

Thanx Vicky... I remember you giving me this info for myself not too long ago, as my NP had suggested it for me as I am now borderline. After reading this I refused to start on Fosomax.. no way no how. :)

chris_at_lucas_RN, RN · Oct 17, 2004

I had an NP insist that I take the stuff. She said if I had concerns I could take protonix the night before so I would not have any acidy heart burn or reflux.

Okay. We're supposed to take it on an empty stomach, I'm gonna stretch here and suggest it is because BEING ALL ABOUT MINERALS it needs the acid and cannot share it with something like food. So we're gonna do something to decrease the amount of acid available to it? I asked her about it and she said (are you ready for this one?) "the pharmaceutical rep said it would be OK to do that."

And the pharmaceutical rep knows and understands any of the research? Or maybe wants to sell more fosamax..... He sure wouldn't be anybody whose authority I would trust, even for whether a tissue was clean....

I immediately dropped the drug as probably too dangerous for my minimal need (I am supposedly just over the line but those things are open to question as the radiologist is also using his "best judgment").

I dropped the NP because I believed (for this and other reasons) that I had ceased to be a patient and had become a "mark." I'm not interested in supporting the medical and pharmaceutical industries.

Interestingly, and maybe I should've put this at the top, I just read a presentation of research done on fosamax. Cellular pics at 160x and all. The conclusion? That more bone ain't stronger bone. There were few if any osteoblasts. Some of the clasts that should've been there weren't there either.

More reason not to take it.

BUT. My 87 year old father-in-law has osteoporosis. He is thin and rather frail, although active, with very few health problems, and with very many good healthy habits. He is taking fosamax. In this case, I support it wholeheartedly. It is unlikely that he will be taking it for 30 years. And very likely that more bone is better than less bone.

I think if we are young (50's) and have no family history and have only "borderline" (if you trust those charlatans at all) bone density results (I was between 0 and -.01), we absolutely do not know what taking the stuff now will mean when we are in our 80's.

And the drug companies sure as heck don't care.

Just my two dollars worth (inflation, ya know! :rotfl: )