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Re: To: ob-gyn-l@obgyn.netFrom: Ronald E. Ainsworth (ainsron@msn.com)Tue Aug 24 15:22:05 1999
>Patient returns this year. States has not done well with taking fosimax >(heartburn, inconvenient time--a.m. dosing). > >Physician consultant suggested Evista. In the past I only used it for >patients in whom estrogen was contraindicated. If used, would premarin be >discontinued? > >Lenora McCall, CNM I see no benefit to this patient to switch to Evista, its bone protection appears only to be for the hips, not the vertebral spine. There is also no reason to place a patient on a SERM, in addition to estrogen, as there is no reason to expect an additive protective effect. The next alternative and has significant osteoporosis that is progressing, if she cannot tolerate Fosamax would nasal calcitonin. Consider a repeat DEXA scan to evaluate for progression.
-- Ronald E. Ainsworth, MD, FACOG Paradise, CA, Private Practice 20 yrs.
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