Bisphosphonates (Fosamax, Boniva, Actonel, Reclast), along with calcium and vitamin D supplementation, are a common conventional treatment for osteoporosis. These drugs are even used for prevention of osteoporosis in those with osteopenia.
Bone tissue continually goes through a cycle of formation of new bone and breakdown of old bone. Bisphosphonates increase bone mineral density in the short term by reducing bone breakdown, essentially reducing bone loss. However, it is not the same as building natural, healthy bone with exercise.  Exercise is essential, and, in particular, exercising the back and legs. Muscle strength is the most accurate way of predicting bone strength and of predicting risk of falls. Strengthening muscles has been shown to be the most effective way to strengthen bone and protect against osteoporosis-related fractures.1 Compared to exercise, medications are relatively ineffective and may cause harm.

Since bisphosphonates accumulate in bone tissue and suppress bone turnover, there has been a concern about the strength and integrity of the medically treated bone. Apparently, the use of bisphosphonates actually causes the bones to become brittle despite the increase seen in bone mineral density.

Several studies have reported the occurrence of specific and rare types of femur fractures in individuals (mostly women) who had been taking bisphosphonates, specifically alendronate (Fosamax), for approximately 4-8 years.2,3,4,5,6,7,8,9Two new studies presented at the American Academy of Orthopaedic Surgeons national meeting this week have drawn more attention to this potential hazard.10 Long term users of alendronate (Fosamax) – were found to be at significantly higher incidence of fractures.11 A frightening detail of these reports is that the fractures had occurred under minimal trauma – these fractures are not from falls. In fact, in most cases, these women were performing low-energy exercise, sometimes just walking down a flight of stairs.12,13

These medications have other serious side effects as well, such as atrial fibrillation a heart rhythm disturbance. Prevention of osteoporosis and bone fractures does not need to involve potentially dangerous drugs.

药品信息
【性状】本品为白色片。
【药理作用】本品是骨代谢调节剂，为氨基二膦酸盐，与骨内羟磷灰石有强亲和力。能进入骨基质羟磷灰石晶体中，当破骨细胞溶解晶体，药物被释放，能抑制破骨细胞活性，并通过成骨细胞间接起抑制骨吸收作用。其特点是抗骨吸收活性强，无骨矿化抑制作用。
【药代动力学】据文献报道，本品口服吸收后主要在小肠内吸收，但吸收程度很差，生物利用度约为0.7%，且食物和矿物质等可显著减少其吸收。本品血浆结合率约80%，血清半衰期短，吸收后的药物大约20%～60%被骨组织迅速摄取，骨中达峰时间约为用药后2小时，其余部分能迅速以原形经肾排泄消除，服药后24小时内99%以上的体内存留药物集中于骨，本品在骨内的半衰期较长，与药的半衰期相仿，约为10年以上。
【适应证】用于治疗绝经后妇女的骨质疏松症。
【用法用量】口服每日早餐前至少30分钟空腹用200ml温开水送服，一次10mg，一日1次。
【不良反应】腹痛，腹泻，恶心，便秘，消化不良，如不按规定服用方法者可有食道溃疡，偶有血钙降低，短暂白细胞升高，尿红细胞、白细胞升高。
【禁忌】食道动力障碍，如食道迟缓不能，食道狭窄者禁用，严重肾损害者、骨软化症患者禁用。
【注意事项】
1．早餐前至少30分钟用200ml温开水送服，用药后至少30分钟方可进食。
2．与桔子汁和咖啡同时服用会显著影响本品的吸收。
3．在服用本品前后30分钟内不宜饮用牛奶、奶制品和含较高钙的饮料。服药后即卧床有可能引起食道刺激或溃疡性食管炎。
4．胃肠道功能紊乱、胃炎、食道不适、十二指肠炎、溃疡病患者慎用。婴幼儿、青少年慎用。
5．轻、中度肾功能异常患者慎用。
6．开始使用本品治疗前，必须纠正钙代谢和矿物质代谢紊乱、维生素D缺乏和低钙血症。补钙剂、抗酸剂和一些口服药剂很可能妨碍本品的吸收，因此，服用本品后应至少推迟半小时再服用其他药物。
7．男性骨质疏松症用药的安全性和有效性尚未验证，不推荐使用。
【相互作用】
1．抗酸药和导泻剂因常含钙或其他金属离子如镁、铁等而会影响本药吸收。
2．与氨基糖苷类合用会诱发低钙血症。
【孕妇及哺乳期妇女用药】安全性不明确，不宜使用。
【儿童用药】长期用药可能影响骨代谢，应慎用。
药品其他信息
【剂型】片剂
---------------------------------------------------------------
产地国家: 美国
所属类别: 骨科药物->治疗骨质疏松药物
原产地英文商品名:
FOSAMAX-70mg/75ml liquid
原产地英文药品名:
ALENDRONATE SODIUM
中文参考商品译名:
福善美-70毫克/75毫升
中文参考药品译名:
阿仑膦酸钠
生产厂家中文参考译名:
默沙东
生产厂家英文名:
Merck & Co., Inc.