Osteoporosis drugs remain at center of growing controversy

Q. I am not yet 50, but my doctor says I have something called osteopenia, which could put me at risk for osteoporosis. She has suggested Actonel but says this decision is up to me. She mentioned that there are some side effects and questions about the quality of the bone that results from this type of treatment. Is it possible that treated bone might not be as strong as that which grows naturally? What else can you tell me about these drugs?

A. There is growing controversy about osteoporosis drugs such as Actonel, Boniva, Fosamax and Reclast (Journal of the American Medical Association, Feb. 18, 2009). Rare but serious complications such as jaw problems, severe muscle, bone and joint pain and unusual thigh-bone fractures have been reported.

One reader shared this story: “I had a right femur fracture in May 2007 and a left femur fracture in February 2008. I had been taking Fosamax or Actonel for about 10 years. Prior to breaking these bones, I had unexplained thigh pain for several years.”

It seems paradoxical that drugs meant to strengthen bones might contribute to unusual fractures. So you can better understand this issue and other pros and cons of osteoporosis treatment, we are sending you our Guide to Osteoporosis. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (59 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. U-92, P.O. Box 52027, Durham, NC 27717-2027. It also can be downloaded for $2 from our Web site: www.peoplespharmacy.com.

Q. What do you know about prescription Lovaza? My eye doctor prescribed it for dry eyes and eye surface damage due to Sjogren’s syndrome.

I have great respect for my doctor, but I would like to know if other forms of omega-3 fats are just as effective. Lovaza is very costly. He also has me taking flax oil.

A. Lovaza is prescription-strength fish oil (omega-3 fatty acids) approved for lowering high triglycerides. A month’s supply may cost more than $160.

Sjogren’s syndrome is an autoimmune disorder characterized by arthritis, dry mouth, dry eyes, dry skin and dry, brittle nails and hair. There is some preliminary evidence that omega-3 fatty acids found in both fish and flax oil might be helpful (American Journal of Clinical Nutrition, October 2005). We see no reason why you couldn’t use high-quality OTC fish oil in lieu of Lovaza.

Q. I read in your column that Detrol might have a negative impact on memory. Both my sister and I have been complaining about memory problems since we started taking it for overactive bladder problems. I phoned my doctor’s office about this issue and was told they have never heard about this reaction at all. Why are doctors not aware of this side effect?

A. Modern medicine is highly compartmentalized. Specialists in one area might not always be aware of developments in another field. That might explain why a urologist could be unaware of the cognitive impact of certain bladder medicines. The Food and Drug Administration has not required drug companies to highlight this complication.

There is increasing evidence, though, that drugs that affect the activity of the brain chemical acetylcholine can impair cognitive function, especially in older people (Neurological Sciences online, Feb. 20, 2009). Medications such as Detrol and Ditropan can cause dry mouth and constipation as well as confusion, disorientation and hallucinations.

XIn their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of The Vindicator or e-mail them via their Web site: www.PeoplesPharmacy.com. Their newest book is “Favorite Home Remedies From The People’s Pharmacy.”

2009 King Features Syndicate Inc.