Fosamax Plus Evista for Osteoporosis

Q.I recently was diagnosed with osteoporosis and prescribed Fosamax. I have been taking Evista for two years. When I asked my doctor why that hadn’t prevented the osteoporosis, he really didn’t have a good answer. He wants me to keep taking the Evista along with the Fosamax. Is this a good idea?

A. Osteoporosis refers to a loss of bone density. Bone density is highest during your early 30s and then diminishes with age. If the bone density drops too low, there is an increased risk of fractures. It’s best to prevent osteoporosis before it occurs. Still, if it does develop, treatment may prevent some fractures.

There are several treatment options for osteoporosis, including Fosamax and Evista, both of which you mentioned. Fosamax is in a new class of medication that has been shown to help increase bone density. Evista is a type of hormone replacement therapy that works best when started soon after menopause. The hormone replacement has been shown to slow bone loss, but unlike Fosamax it does not increase the bone density.

Your question about taking Evista along with Fosamax is an important one. There have been studies showing the benefits of combining hormone replacement, such as Evista, with Fosamax. At this point I don’t see any harm in combining the two, and I do agree with your physician that there may be some benefit. There is a lot of research currently being done on osteoporosis, and within the next several years I expect new options to be available for its treatment.

In addition to Evista and Fosamax, you should make sure you are getting an adequate supply of calcium and vitamin D (which helps your body absorb the calcium). In this country it is rare to find people that are deficient in vitamin D; rather, people have to be careful about taking too much, since high levels can be toxic. Weight-bearing exercise also plays an important role in preventing bone loss. Astronauts in the weightless environment of space are at risk for developing osteoporosis, which is why NASA has started an exercise program for astronauts who are going to be in space for an extended period of time.

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