Drug Uses

Fosamax is indicated for treatment and prevention of osteoporosis in postmenopausal women. For the treatment of osteoporosis, Fosamax increases bone mass and reduces the incidence of fractures, including those of the hip and spine. It is also indicated for the prevention of osteoporosis, treatment to increase bone mass in men with osteoporosis, treatment of glucocorticoid. It is used to treat induced osteoporosis in men and women receiving glucocorticoids in a daily dosage equivalent to 7.5 mg or greater of prednisone and who have low bone mineral density, treatment of Paget's disease of bone in men and women.

How Taken

Fosamax comes as a tablet to take by mouth. It should be taken once a day in the morning on an empty stomach. Fosamax should be taken with a full glass (6-8 ounces) of plain water. Wait at least 30 minutes after taking Fosamax before you eat, drink, or take other medications. Do not take Fosamax with mineral water, coffee, orange juice, milk, or other dairy products. Do not suck or chew the tablet; swallow the tablet whole. Do not lie down for at least 30 minutes after taking Fosamax. Standing or sitting upright helps you get the full dose and decreases heartburn or the risk of injury to your esophagus.

Warnings/Precautions

Before taking Fosamax, tell your doctor if you have a problem swallowing, such as a narrowing of the esophagus; have esophageal ulcers or an esophageal disease; have a condition that causes low levels of calcium in the body; have kidney disease; have stomach ulcers or other stomach or digestive problems; or are unable to stand or sit upright for at least 30 minutes. You may not be able to take Fosamax, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above. Fosamax is in the FDA pregnancy category C. This means that it is not known whether Fosamax will be harmful to an unborn baby. Do not take Fosamax without first talking to your doctor if you are pregnant or could become pregnant during treatment. It is not known whether Fosamax passes into breast milk. Do not take Fosamax without first talking to your doctor if you are breast-feeding a baby.

Missed Dose

If you take Fosamax every day and you miss a dose, skip that dose and take the next regularly scheduled dose the following day. Missing one dose will not affect your treatment. Do not take two tablets at the same time. If you take a Fosamax once a week and you miss a dose, take the missed dose on the morning after you remember. Do not take two tablets on the same day. Return to taking one tablet once a week, as originally scheduled on your chosen day.

Possible Side Effects

Stop taking Fosamax if you experience any of the following serious side effects: an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives); Seek emergency or talk to your doctor if you have difficulty or pain when swallowing; chest pain; pain or burning under the ribs or in the back; or new or worsening heartburn. Other, less serious side effects may be more likely to occur. Continue to take Fosamax and talk to your doctor if you experience abdominal discomfort; stomach upset, nausea, vomiting, diarrhea, or constipation; headache; muscle, bone, or joint soreness or aches; eye pain; a rash; or an altered sense of taste. Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

Storage

Store in a well-closed container at room temperature, 15-30°C (59-86°F).

Overdose

Hypocalcemia, hypophosphatemia, and upper gastrointestinal adverse events, such as upset stomach, heartburn, esophagitis, gastritis, or ulcer, may result from oral over dosage. If you do think that an overdose has occurred, call an emergency room or poison control center.

More Information

Follow you doctor's recommendations about drinking alcohol and smoking. These activities are related to decreased bone density. Antacids and other medicines taken by mouth may decrease the effects of Fosamax. Do not take any other medicines within 30 minutes after a dose of Fosamax. Talk to your doctor before taking any other medicines during treatment with Fosamax.

Disclaimer

This drug information is for your information purposes only, it is not intended that this information covers all uses, directions, drug interactions, precautions, or adverse effects of your medication. This is only general information, and should not be relied on for any purpose. It should not be construed as containing specific instructions for any particular patient. We disclaim all responsibility for the accuracy and reliability of this information, and/or any consequences arising from the use of this information, including damage or adverse consequences to persons or property, however such damages or consequences arise. No warranty, either expressed or implied, is made in regards to this information.

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Menopause is the transition period in a woman's life when her ovaries stop producing eggs, her body produces less estrogen and progesterone, and menstruation becomes less frequent, eventually stopping altogether.
Causes, incidence, and risk factors
Menopause is a natural event that normally occurs between the ages of 45 and 55.
Once menopause is complete (called postmenopause), you can no longer become pregnant.
The symptoms of menopause are caused by changes in estrogen and progesterone levels. As the ovaries become less functional, they produce less of these hormones and the body responds accordingly. The specific symptoms you experience and how significant (mild, moderate, or severe) varies from woman to woman.
In some women, menstrual flow comes to a sudden halt. More commonly, it tapers off. During this time, your menstrual periods generally become either more closely or more widely spaced. This irregularity may last for 1 to 3 years before menstruation finally ends completely.
A gradual decrease of estrogen generally allows your body to slowly adjust to the hormonal changes. When estrogen drops suddenly, as is seen when the ovaries are removed surgically (called surgical menopause), symptoms can be more severe.
Because hormone levels fall, changes occur in the entire female reproductive system. The vaginal walls become less elastic and thinner. The vagina becomes shorter. Lubricating secretions from the vagina become watery. The outside genital tissue decreases. This is called atrophy of the labia.
Symptoms
The potential symptoms include:
* Hot flashes and skin flushing
* Night sweats
* Insomnia
* Mood swings including irritability, depression, and anxiety
* Irregular menstrual periods
* Spotting of blood in between periods
* Vaginal dryness and painful sexual intercourse
* Decreased sex drive
* Vaginal infections
* Urinary tract infections
In addition, the long-term effects of menopause include:
*
Bone loss and eventual osteoporosis
*
Changes in cholesterol levels and greater risk of heart disease

Signs and tests
Blood and urine tests can be used to measure hormone levels that may indicate when a woman is close to menopause or has already gone through menopause. Examples of these tests include:
* Estradiol
* FSH
* LH
A pelvic exam may indicate changes in the vaginal lining caused by changes in estrogen levels. A bone density test may be performed to screen for low bone density levels seen with osteoporosis.
Treatment
Menopause is a natural process. It does not require treatment unless the symptoms, such as hot flashes or vaginal dryness, are particularly bothersome.
One big decision you may face is whether or not to take hormones to relieve your symptoms. Discuss this thoroughly with your doctor, weighing your risks against any possible benefits. Pay careful attention to the many options currently available to you that do not involve taking hormones.
If you have a uterus and decide to take estrogen, you must also take progesterone to prevent endometrial cancer (cancer of the lining of the uterus). If you do not have a uterus, progesterone is not necessary.
HORMONE REPLACEMENT THERAPY
For years, hormone replacement therapy (HRT) was the main treatment for menopause symptoms. Many physicians believed that HRT was not only good for reducing menopausal symptoms, but also reduced the risk of heart disease and bone fractures from osteoporosis . However, the results of a major study -- called the Women's Health Initiative -- has led physicians to revise their recommendations.
In fact, this important study was stopped early because the health risks outweighed the health benefits. Women taking the hormones did see some benefits. But they greatly increased their risk for breast cancer, heart attacks, strokes, and blood clots.
If your symptoms are severe, you may still want to consider HRT for short-term use (2-4 years) to reduce vaginal dryness, hot flashes, and other symptoms.
To reduce the risks of estrogen replacement therapy and still gain the benefits of the treatment, your doctor may recommend:
* Using estrogen/progesterone regimens that do not contain the form of progesterone used in the study.
* Using a lower dose of estrogen or a different estrogen preparation (for instance, a vaginal cream rather than a pill).
* Having frequent and regular pelvic exams and Pap smears to detect problems as early as possible.
* Having frequent and regular physical exams, including breast exams and mammograms.
ALTERNATIVES TO HRT
The good news is that you can take many steps to reduce your symptoms without taking hormones:
* Dress lightly and in layers
* Avoid caffeine, alcohol, and spicy foods
* Practice slow, deep breathing whenever a hot flash starts to come on (try taking six breaths per minute)
* See an acupuncturist
* Use relaxation techniques like yoga, tai chi, or meditation
* Eat soy foods
* Remain sexually active to preserve elasticity of your vagina
* Perform Kegel exercises daily to strengthen the muscles of your vagina and pelvis
* Use water-based lubricants during sexual intercourse
There are also some medications available to help with mood swings, hot flashes, and other symptoms. These include low doses of antidepressants such as paroxetine (Paxil), venlafaxine (Effexor), bupropion (Wellbutrin), and fluoxetine (Prozac), or clonidine, which is normally used to control high blood pressure.

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