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Osteoporosis

Mayacalcin, Evista, and Actonel

11/13/2006

Question:

at 57 years of age, I just found out that my spine T-score is -2.2, and both femoral neck scores are -1.2. My gynocolofist is recommending Evista or Actonel. My dentist mentioned Calcitonin. There is so much information that is getting me confused when I also think of my own personal health history. My mother died of a blod clot and I have a tendency to get gastro intestinal reactions when stress gets intense. Is there a risk factor with the side effects I am reading bout Evista and Actonel? What about Calcitonin?

Answer:

Calcitonin is approved for the treatment of osteoporosis in women who are five years beyond their last menstrual period.  It was not found to be effective at less than 5 years.  The other drugs approved for osteoporosis are considered to be more effective.

With your family history of blood clots, I would recommend checking for coagulation abnormalities prior to using Evista.  Actonel and other bisphosphonates have been associated with the rare condition of osteonecrosis of the jaw.  The majority of cases have occurred in cancer patients who were receiving intravenous bisphosphonates and who under went a dental procedure that involved the jaw bone.  If you are in need of dental work, have it done prior to starting a bisphosphonate.  You can always stop the medication at times of stress if you are having GI problems or if you need to have dental work done that involves the jaw bone.

For more information:

Go to the Osteoporosis health topic, where you can:

Response by:

Margery Gass, MD Margery Gass, MD
Formely, Professor, Clinical Obstetrics & Gynecology
College of Medicine
University of Cincinnati