I already have osteoporosis from prednisone, and possibly gluten. One of my doctors put me on once-a-month Actonel, which is in the same family of meds as Fosamax and Boniva. I took one dose and don't plan to ever take another. It gave me horrible side effects that lasted 4 weeks--nausea, dizziness, headache, muscle, bone, and joint pain, etc. Then I spoke to another doctor who put me on a supplement called strontium citrate. (I use Strontium Bone-Maker from Doctors Best.) Her only directions were to take 2 each evening, and to make sure that I took them at least 4 hours apart from my calcium-magnesium. I've been on it for 2-1/2 years and have never had a bad side effect. On the flip side, a friend of mine has been on Fosamax for years with no seeming problems, although she recently fell and broke her shoulder.

There are 2 places you might want to check regarding this med. One is the Osteoporosis forum here on DS. You can read the experiences of others. Also, check the askapatient.com website about Fosamax (link below). You can read the comments that users of this med have written.
http://www.askapatient.com/viewrating.asp?drug=20560&name=FOSAMAX

One more consideration, check with your dentist, because some dentists will not work on you if you are taking certain osteo meds.

I took two pills 10 day apart and got a gi burn that lasted for months, bone aches and pains, it was terrible.
I think you should conslut with an endochrinologist and take that decision out of the rheumy's hands. I did and i am so glad. I have qualified for Prolea, and am considering it, but only because i am now again on high dose. My vegan diet took me from osteopenia to not osteopenia in 6 months... this is a topic that is not well understood. I k now it is the standard, but none of us are standard.
Keep researching and see how it goes...
Shawna

I've been taking high dose prednisone since the end of June... They started me on Fozamax 10 weeks ago. My mother, almost 2 decades ago, had terrible experiences with Foxamax hurting her esophagus. They didn't know everything they do now about the risks of this drug - they only knew the benifits, so she ended up with voice box damage and Barretts Esophagus. So I was very very scared and cautious when I was told to start taking this drug. But with my family history of osteoporosis (mom was the youngest hip break due to Osteo that they had ever seen in 1990) I knew that my risk was high enough that I needed to do something if I was going to be on prednisone long term. So I took it. I also took the liberty of adding Prilosc OTC to my meds. Never-the-less, about six weeks in I started waking up in the middle of the night with terrible chest pain, which after a few nights of that - went to the ER. It hurt so bad, I thought maybe my heart was being affected by my lung disease... But they concluded was likely heartburn/acid reflux from taking the fozamax. I wanted to stop taking it, but my PCP talked me into taking a heartburn med and giving it a few weeks. So, I started taking nexium and within a few days, the pain subsided.
My best advice in regards to this medication is to follow the directions to the letter! (First thing in the AM, with 6oz of water - do not lay down again... wait at least 30 minutes (but they would prefer 1 1/2 hours - then take any other medications and eat a healthy, low acid breakfast.)
I haven't had any trouble since then. It never made me feel sick after taking it or anything.
The heartburn related chest pain was my only real side-effect I experienced and once they got me on a strong acid reflux medication (Nexium) it went away. I am still cautious, and if I start having any more heartburn or throat issues, I admit that I will reconsider taking it. But with my family history, I feel like it's important for me to preserve my bones.
If your bones area already stong, I'd say to do all you can to keep them that way within reason. You can always try it short term and see how it affects you.
Good Luck!

Thanks guys. I know that the pharmacist was adamant about following directions about empty stomach, 8 Oz water, 30 minutes standing or sitting, no tight clothes not on methotrexate day, then low acid high protein breakfast. My cousin takes this and has no problem. I like Shawna's idea, but my spouse would have to take another day off work :(. So we'll give it a shot. Doc said when I got to below 30 mg of prednisone I can drop the Fosomax. So someday......

Do some more research on Fosamax and all the bone builders, there are some terrible side effects and it is not all it is cracked up to be. I think you can ask to wait especially if your bone density was 130%. I am not one for more meds...
Shawna

After reading up on the downside of Fosamax, I discontinued it after 6 weeks of having a 3 day heartburn after each dose, and began taking calcium supplement with Vitamin D daily. Rheumy not happy about it, but sometimes we have to decide for ourselves.

I come from a long line of solid bones and rheumy would not ok an initial bonescan to have a baseline. This was another factor in my decision.

I've been doing calcium 2 day, 1200mg and vitamin d. I'll do some homework on this. And I misspoke, I'm 30% over the bone density of a 20 year old female. Probably from weight lifting. But I don't want to lose it, for sure!

I took Fosamax for quite a few years, but discontinued it after reading that it really does no good after two years of being on it. Wish I had known that sooner. When I mentioned it to several doctors, they knew it too, but none ever told me.

Dr. John McDougall certainly does not recommend any of those types of medications. His explanation is that the recommended bone density is based on 28-year old women, and as we get older we have no need to carry all that calcium around. Anyway, I think it pays to d our own research and then discuss it with the doctors.

Spinal fractures are the biggest side affect of Prednisone on the bones. If this prevents that, and I don't have problems with the meds, it'll be worth it. But I won't know until my first dose.....

I absolutely wouldn't take it based on your first density scan. I've been on Prednisone for 5 years and my bone scans have always been good. I absolutely refuse to take any more medication without significant understanding why I am taking it and absolutely won't take something for a disease I don't even have yet because they are scared I might get it. It isn't guaranteed you will.

My feeling is Rheumy's aren't very comfortable with Prednisone and want you off as quickly as possible. Neurologists tend to be more comfortable with it. You can probably guess I see a Neurologist.

Fosomax is no joke and does have side effects. I would stick with the Calcium and Vit D 2 X a day and get another scan in 6 months. Consider this one a baseline.

I take Caltrate with vitamin D 2X a day. It is 1200 mg of calcium each day (600 each dose). I have learned Caltrate is easier for your body to absorb. Calcium is very difficult to absorb overall. Anything your body doesn't use is released out of your body within a few hours. At least that is what I learned.

Wonup, I quit taking Boniva injections due to having frequent infections with my DM. If you take a bisphosphonate, you can NOT have an infection going on or else you are at risk for osteonecrosis of the jaw. You may not know that you even have an infection going on with DM/PM.

I have a terrific book that discusses all the bisphosphonates, the complications, and the foods to eat that are best for osteoporosis. I think this book is excellent. The book is: Your Bones, How You Can Prevent Osteoporosis & Have Strong Bones for Life by Lara Pizzorno, MA, LTM with Johnathan V. Wright, MD.
This book even has pictures of osteonecrosis of the jaw.

I hope this helps.

Thanks everyone for your insights. I've been reading the research reports, but also the reports about how prednisone contributes to decreased quality of life through bone density depletion. My Rheumy does.think there is about a three year cycle to this disease, and I may be on MTX and Prednisone for years, so some preventive measures might be in order. With prednisone, I may not be able to laydown calcium calcitrate fast enough to prevent bone loss. Biophosphates don't add calcium to bones, they slow the deterioration and allow the calcium I'm taking to be effective. So I'm still considering, but got the prescription anyway, and if I decide to take it, tomorrow is my first dose. Jaw problems have a higher rate with injections over the tablets, I understand....