Fosamax® is a bisphosphonate medication, marketed, advertised, distributed and sold for the treatment of osteoporosis and Paget’s Disease. The drug is manufactured by Merck, and has additionally been prescribed for off label uses such as bone cancers. Motley Rice LLC is currently investigating its possible connection with osteonecrosis of the jaw (ONJ), also known as dead jaw disease, jaw death, bisphossy jaw, and avascular or aseptic necrosis of the mandible/maxilla. This painful and disfiguring condition causes the jaw bone to decay and die as a result of infection of the jaw and exposed portions of bone inside the mouth. Symptoms may take weeks or months to become evident, and may develop following trauma to the tooth, such as an extraction, or other dental surgery performed exposing jaw bone. While almost all cases of ONJ have occurred following dental work, several cases have been reported to occur in the absence of dental work where bone is exposed and subject to infection.
Fosamax® is in the non-nitrogenous class of bisphosphonates, meaning it contains a nitrogen atom. Other drugs within this class such as Aredia® and Zometa® are also used as chemotherapy, but are not indicated for use in non-cancerous conditions such as osteoporosis. The Physician’s Desk Reference (PDR) for Fosamax® confirms that the molecule contains a nitrogen atom.
Throughout the 1990s and 2000s, medical articles and studies appeared reporting the frequent and common occurrence of osteonecrosis of the jaw with the use of nitrogenous bisphosphonates used for chemotherapy. As with its reported and acknowledged side effects concerning irritation, erosion, and inflammation of the upper gastrointestinal tract, we believe Merck knew or should have known that Fosamax®, as a nitrogenous bisphosphonate, shared an adverse event profile similar to that of the other drugs within this specific subclass of bisphosphonates. Similarly, we believe Merck knew or should have known that bisphosphonates also inhibit the development of blood vessels in an organism or tissue of the affected area, resulting in an inadequate supply of blood, specifically to patients' mandibles (lower jaws) and maxillae (upper jaws), appearing to be cumulative in nature. As a result, a minor injury or disease can turn into a non-healing wound. That in turn can progress to widespread necrosis (bone death) and osteomyelitis (inflammation of bone marrow).
More recently, an article about bisphosphonate-associated osteonecrosis of the jaw in the Oregon Dental Association’s March 2006 newsletter cited an increasing number of complications associated with the use of bisphosphonate drugs, and specifically names Fosamax® as being “associated with development of a disorder involving non-healing, necrotic exposure of bone in the jaws” and uses the term “bisphosphonate-associated osteonecrosis of the jaw” (BONJ).
Dentists are now being advised by some state dental associations to refrain from using any invasive procedure (such as drilling a cavity) for any patient on Fosamax®. Once osteonecrosis begins and becomes symptomatic, it is very difficult to treat and is not reversible.
Motley Rice LLC is committed to helping people who have been harmed by pharmaceutical drugs such as Fosamax®. For those who have suffered from ONJ or BONJ, the symptoms can be devastating. If you or a loved one has been affected by the significant complications arising from the use of Fosamax®, or if you would like to learn more, please contact attorney Carmen S. Scott (SC) at (843) 216-9160 or cscott@motleyrice.com for more information.
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