Evaluating Jaw Pain Associated with Fosamax Use
I am a 36-year-old male, standing at 179.5 cm tall and weighing 104 kg. I don't smoke and do not have issues with alcohol consumption. For the past three years, I have been taking Fosamax to manage osteoporosis resulting from prolonged use of prednisolone (initially at 40 mg and gradually tapering to 5-10 mg daily over approximately three years) for a cardiac condition known as sarcoidosis. Currently, I also take a weekly dose of 10 mg Methotrexate. My latest dual-energy X-ray absorptiometry (DXA) scan, conducted in December 2024, revealed a Z-score of -2.5 for my lumbar spine. Thankfully, there are no fractures, and there has been a slight improvement in my condition after three years of treatment. Recently, I have experienced persistent pressure and pain in my jaw, particularly between my upper molars and ear. This discomfort tends to arise exclusively during the period when I am taking Fosamax, disappearing once I cease its use. Additionally, I have been suffering from deep aches in my femur; however, three CT scans returned normal results. Both my general practitioner and the specialist at the hospital have indicated that this pain does not correlate with my use of Fosamax and have advised against discontinuing the medication. I am now contemplating whether to stop taking Fosamax for good. My plan involves undergoing annual DXA scans to monitor my condition and potentially considering alternative treatments, such as teriparatide, if necessary in the future. Does this course of action seem medically sound, or would there be considerable risks associated with stopping the medication?
Answers (1)
7/19/2025, 3:30:58 PM
OpenHealth AI
It sounds like you're facing a challenging situation with your jaw pain while on Fosamax, especially given your history of osteoporosis due to prednisolone use. You’re thoughtfully considering your options, and it's important to weigh the benefits of your current medication against the side effects you’re experiencing.
Main Points:
- Jaw pain could be related to Fosamax, but your doctors believe it is not.
- Discontinuing Fosamax may have implications for your bone health, especially given your osteoporosis diagnosis.
- Regular monitoring and considering alternatives like teriparatide may be valuable.
Explanation: Fosamax (alendronate) is a bisphosphonate used to treat osteoporosis. While it can sometimes be linked to jaw pain or osteonecrosis of the jaw (particularly in those taking high doses or with dental issues), the majority of people tolerate it well. Your jaw pain coinciding with the timing of Fosamax is noteworthy, but it’s good that your doctors advise against discontinuation based on their evaluations.
It's essential to follow a careful monitoring plan given your osteoporosis diagnosis. Your Z-score of -2.5 indicates a significant reduction in bone density, which puts you at higher risk for fractures. Stopping treatment could lead to further deterioration unless effectively managed.
Next Steps:
- Keep a Symptom Diary: Track the frequency and intensity of your jaw pain and any other related symptoms to provide more detailed information to your healthcare team.
- Discuss Pain Management: Work with your healthcare providers to find ways to manage the jaw pain, whether that involves changes in dental care, lifestyle adjustments, or pain relief strategies.
- Consider a Holistic Review: Request a thorough evaluation of all your medications and their potential interactions or side effects. A reassessment of your osteoporosis management plan may reveal insights or alternatives.
- Monitor Your Bone Health: Continue with your annual DXA scans and maintain communication with your healthcare providers regarding any changes in your condition.
If you feel your jaw pain persists or worsens despite monitoring, or if your general health changes, it’s vital to communicate this to your healthcare team. They may consider alternative treatments or further investigations. Your proactive approach in seeking information and planning for your health is commendable, and I encourage you to stay engaged with your healthcare providers.
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