Fosavance
Fosavance has been launched by MSD. This product contains Alendronate 70mg and colecalciferol 70micrograms in a once a week tablet. It will be priced at the same level as Fosamax, that is an NHS List price of £22.80 for 4 tablets.
It is licensed for the treatment of postmenopausal osteoporosis in patients at risk of vitamin D insufficiency. Further information is available in the Summary of Product Characteristics.
At present, Bisphosphonates (like Alendronate) are recommended for use in addition to a suitable Calcium and Vitamin D supplement. This product is being promoted based upon the fact that population data in the UK shows that the vast majority of people obtain sufficient calcium from their diet. The exception to this appears to be female patients who are aged over 65 and who live alone.
This product is an attempt at patent extension by the manufacturers of Fosamax as the patent is due to expire very soon. The place for this product remains unclear at present as supplementation with Calcium and Vitamin D supplements is the current empirical treatment.
Additionally, it may be difficult to assess the risk of Vitamin D insufficiency in order to comply with the product license. The skin produces Vitamin D naturally during exposure to sunlight.
Action: This product should not be used in preference to standard treatment (Calcium and Vitamin D supplement with or without a Bisphosphonate) until further data can demonstrate that Calcium supplementation is not required in patients who have already suffered an osteoporotic bone fracture, especially as patients with "postmenopausal osteoporosis" are likely to be female patients who are over 65 and living alone.
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Your answers are much appreciated, thank you. As for the osteoporosis / osteopenia, some sites (hip / lower back) which tested osteoporotic at first scan, showed improvement and were pronounced osteopenic at second scan after a year. Some sites which tested osteopenic at first scan showed improvement and tested normal at second scan. But then there was also a reversal in one or two sites which showed slight deterioration. Jogging etc is impossible and painful due to all the steel keeping my knee and ankle together, although the bones in both have healed well. Walking I do as much as time allows. Thanks for the advice.
Four more Q's if I may. 1) Is the testosterone (HRT) a definite advantage to the bones and commonly prescribed? 2)Could the dexa scanner be suspect and should I try another machine for the next yearly test to check if there are any major differences. In other words how reliable and accurate are these scanners? 3) How common is my condition among males of my age? 4) Is there any particular osteo specialist or research group you could recommend in South Africa, as the GP's, the orthopaedic surgeons who fixed my fractures, and the urologist who prescribed the HRT are still confounded regarding my condition after five years.
Please do not hesitate to indicate if I am imposing on your time with my questions. Many thanks.
Comment by Grant Swart — October 20, 2010 #
@Grant,
I understand a little more about your diagnosis now, but if some sites were indicating osteoporosis then that is your condition even if other sites indicate osteopenia. You take the worst site and base the diagnosis on that. If you can't jog due to pain then fair enough, walk as best you can.
In answering your questions, testosterone is involved in bone metabolism so it seems like a good idea. ALL tests involve the acceptance of a degree of error, so if you had been put through the same DEXA scanner twice in a short period (so literally scanned twice in succession) you would likely get different results. Essentially, don't worry to much about the individual results, try to look at the overall picture - which sounds like an overall improvement.
I'd say the condition would be rare in a male of your age and I expect this is why your doctors are so puzzled. That said, if you read about how osteoporosis is diagnosed, it is based on standard deviations compared to a 'population normal', so there will always be people with low bone mineral densities and people with high bone mineral densities. The difference with you is that this has been identified after your fractures and is now being treated. I'm afraid I don't know of any specialists or clinics in South Africa, that is something you need to ask your doctors about.
Comment by Matthew Robinson — October 21, 2010 #
@Grant,
I suspect you have osteoporosis but not osteopenia. The conditions are both about bone loss but osteoporosis means you've lost more bone than osteopenia.
But, you are on the right treatment. It is normal to get fluctuations in your bone mineral density so don't worry about that too much.
Ask your doctor about your toes, I'm not aware that this is related to treatment but it is possible. As for the long bone fracture risk, the disadvantages of treatment in this respect are still lower than the benefits in terms of prevention of other fractures.
You should make sure you are taking weight bearing exercise if possible to ensure that you are 'exercising' your bones. By weight bearing, I mean walking, jogging and running rather than swimming or cycling.
Comment by Matthew Robinson — October 14, 2010 #
4 questions please. I am a 46 year old male and was diagnosed with osteoporosis and osteopenia at approx age 42. That was after two very serious but very unusual fractures of the knee and later the ankle. In addition to Fosavance I have a monthly injection of testosterone and I use a calcium supplement. In other respects I lead a pretty normal working life. 1) After 1 year on Fosavance, dexa scan showed I had a 10,7% overall increase. After 2 years I showed a 4,6% overall loss again. Is this normal? 2) I have seen developing excess bone growths on the side of each big toe, is this known? Could it be Fosavance related? 3) Today there were warnings posted all over the international news concerning the increased risk of femur fracture among users of Fosamax and other alendronates. Is this a problem I should be concerned about? 4) What other treatment should I be getting?
Comment by Grant Swart — October 14, 2010 #
@June,
The joint pain is a known side effect of one of the active ingredients. It may pass with a little more time but probably not. The cracking you are feeling is probably the same problem, I suggest you return to or doctor for a check.
Comment by Matthew Robinson — June 28, 2010 #
I have been on Fosavance going onto my 3rd week and have very sore joints and they seem to be cracking which they didnt do before. Will the sore joints eventually disipate once my body gets used to it?
Comment by JUNE TASKER — June 27, 2010 #
I have been diagnosed with osteoporosis at 50, at point 3, spinal and hip. I have been on Fosamax before and had acid reflux and uncomfortabel osophogus burns. The drug was dicontinued. I have now been prescribed by the same doctor Fosavance with Vit D, as my conditon is 30% bone loss and its serious? the other possibility suggested was the intravenous injection of Zolindronic Acid. This however seems to be a very severe drug. I am not sure what route to take. I am prepared to try the Fosavance again, but if it causes the same reactions will have to look at other options?
Comment by Heike Laufer — March 17, 2010 #
I was on Fosamax for nine months and suffered severe head & ear discomfort.It was only after a Cat scan to help peace of mind brain cancer etc that my thoughts turned to my medication.I stopped taking it & days later I started feeling ok.Obviously I need to take something for my condition.Maybe Fosavance? I must say my bone density test after nine months on Fosamax were exellent.
Comment by Jean Ford — March 15, 2010 #
@Jean,
Fosavance contains the same active ingredient as Fosamax with the addition of Vitamin D. If we attribute your symptoms to the Fosamax then I suspect that you would most likely have the same issues with Fosavance. I think you should talk to your doctor about possible alternatives.
Comment by Matthew Robinson — March 15, 2010 #
After taking Fosavance for 5 weeks I noticed scalp hair loss and hence I stopped it. I am waiting to see if this has caused my scalp hair loss. I am going to see my doctor regarding this. What advice can you give me to control hair loss that is due to Fosavance and what is my alternative to treat osteoporosis??
Comment by prabha — May 19, 2009 #
Prabha,
Alendronate (the main active ingredient in Fasavance®) has been reported to cause alopecia but this is very rare. There are alternatives to alendronate but you'd have to speak to your doctor to see if these are suitable for you.
Comment by Matthew Robinson — May 22, 2009 #
I have been taking FOSAVANCE for one month but, I could not find any more and the druggist changed it by FOSOMAX.Please tell me the difference and should I take it?
Comment by Masoum — April 3, 2009 #
Masoum,
The difference is that Fosavance additionally contains Vitamin D. If you have concerns that you may not be getting enough Vitamin D from other sources (diet and exposure to sunlight) then talk to your doctor.
Comment by Matthew Robinson — April 3, 2009 #
Christine,
If you have stopped taking the Fosavance for two weeks and there has been no change in your symptoms it is unlikely to be a local irritation caused by the medication. You should see your doctor for a check up.
Comment by Matthew Robinson — January 16, 2009 #