- With Mayo Clinic internist
Sandhya Pruthi, M.D.
read biographyclose windowBiography of
Sandhya Pruthi, M.D.
Sandhya Pruthi, M.D.
Dr. Sandhya Pruthi, certified by the American Board of Family Practice, has been practicing medicine at Mayo Clinic since 1995 with special interests in breast diseases and women's health.
She is a consultant in the Department of Internal Medicine, Division of General Internal Medicine, and the Breast Diagnostic Clinic. She is an assistant professor of medicine at Mayo Clinic College of Medicine in Rochester, Minn.
The Winnipeg, Manitoba, native stresses education and patient-related research and has been active in both areas since joining Mayo Clinic. She is the primary investigator at Mayo Clinic of several clinical trials evaluating new agents for the prevention of breast cancer and identification of biomarkers for early detection of breast cancer. Her other research and clinical interests include managing the health of women who are at increased risk of breast cancer, breast pain and hot flashes, and developing patient education decision-making tools for breast-related concerns. She is director of the Breast Diagnostic Clinic and is a member of the Women's Health Executive Committee. Dr. Pruthi has been newly elected as a member to the board of directors for the American Society of Breast Disease. She has assisted with a variety of articles for MayoClinic.com.
"Having an opportunity to share information with my patients in the way that will help them to understand and be able to make educated decisions about their own health is very important to me," she says.
"The Web has become a major information site for people, and I want them to get the best and accurate information to be able to make informed choices for themselves, their family members and friends."
Risk factors (1)
- High-protein diets: Are they safe?
Treatments and drugs (3)
- Osteoporosis medications: Must they be taken indefinitely?
- Osteoporosis and long-term prednisone use: Is there a connection?
- Fosamax and osteonecrosis: Is there a link?
Prevention (4)
- Calcium supplements: Which type is best?
- Chocolate: Does it impair calcium absorption?
- Calcium supplements: Should they be taken with meals?
- see all in Prevention
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Question
Fosamax and osteonecrosis: Is there a link?
Is Fosamax a safe medication? I'm concerned about taking it because of its possible link to osteonecrosis.
Answer
from Sandhya Pruthi, M.D.
Yes, alendronate (Fosamax) is safe for the majority of people who take it. But it may pose a risk of a rare jaw disorder (osteonecrosis of the jaw) in certain people. The cause of this isn't clear.
Fosamax belongs to a class of drugs called bisphosphonates, which are used to treat and prevent osteoporosis. Some bisphosphonates are taken orally, and others are taken intravenously. This class of drugs is also used to treat some bone cancers.
Since 2003, there have been reports of a possible link between bisphosphonates and a rare disorder called osteonecrosis, or "death of bone," involving the jaw — a condition marked by pain, swelling, infection and exposed bone. The majority of cases of osteonecrosis of the jaw involved people with cancer who were receiving chemotherapy and had been given intravenous bisphosphonates to treat cancer that had spread (metastasized) to the bone.
However, a small number of cases of osteonecrosis of the jaw have been reported in people taking oral bisphosphonates — such as Fosamax — for osteoporosis. These have been primarily associated with active dental disease or a recent dental procedure, such as a tooth extraction.
Osteonecrosis of the jaw is a serious disorder. But so is osteoporosis. If you take a bisphosphonate for osteoporosis, don't stop taking the medication without consulting your doctor.
Keep in mind that the risk of developing osteonecrosis of the jaw due to bisphosphonate use is very low in people without cancer or dental problems. If your doctor recommends a bisphosphonate for osteoporosis, consider getting any needed dental work done before starting this medication. If you currently take an oral bisphosphonate and need a dental procedure, you should discuss this with your doctor and dentist.
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