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(no subject)From: Geffrey Klein, MD (gklein@icsi.net)Tue Aug 24 15:45:10 1999
> I have a patient who is a 50 y/o white female. Last year I saw her for a > yearly and ordered a baseline dexa because of a family history of > osteoporosis and her hx of surgical menapause 15 years ago. She had > originally been on premarin 1.25, later .9, now .625. The scan revealed > osteopenia in her spine and osteoporosis in her hips. I started her on > fosimax 20 mg daily, 1500 mg calcuim daily, and advised daily >weight-bearing > exercise. > > Patient returns this year. States has not done well with taking fosimax > (heartburn, inconvenient time--a.m. dosing). Part of the reason might be the dosage and the way that she is taking the medication.
>From the package insert: Oral administration *Administer in the morning with a full glass of water (6-8 oz.) at least 30 minutes before the first food, beverage, or medication. *To avoid esophageal irritation, do not lie down, eat or drink for at least 30 minutes post dose. For the treatment or prevention of osteoporosis: *for the treatment of osteoporosis in postmenopausal women: Oral dosage: Adult females: The FDA-approved dosage is 10 mg PO once daily. Safe use for longer than 4 years has not been evaluated. Supplemental calcium and vitamin D must be given if dietary intake is inadequate. Shortly after alendronate was approved, a study of postmenopausal women with osteoporosis was published that reported a dose of 5 mg PO once daily for 3 years was less effective than 10 mg PO once daily for 3 years. A third regimen of 20 mg PO once daily for 2 years followed by 5 mg PO once daily for 1 year was similar in efficacy to the 10 mg PO once daily regimen.[1318] _______________________ Geffrey H. Klein, MD -- _______________________ geffrey.klein@obgyn.net 17448 State Hwy 3 Suite 200 Webster, Texas 77598 (713) 741 2273 ext 2628
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