From the Guidelines
When ordering Alendronate (Fosamax), it is essential to follow the guidelines for the general population from the National Osteoporosis Foundation, which includes recommendations for supplemental calcium and vitamin D3, as well as treatment options to increase bone density, such as alendronate (70 mg orally weekly) for men with a 10-y probability of hip fracture of 3% or a 10-y probability of a major osteoporosis-related fracture of 20% 1.
Key Considerations
- A baseline DEXA scan should be obtained before starting therapy in men at increased risk for fracture based on FRAX screening 1.
- Treatment options, including alendronate, denosumab, and zoledronic acid, increase bone mineral density, a surrogate for fracture risk, during ADT for prostate cancer 1.
- The serum level of 25-hydroxy vitamin D and average daily dietary intake of vitamin D will assist in making a patient-specific recommendation for vitamin D supplementation 1.
Monitoring and Follow-up
- A follow-up DEXA scan after 1 year of therapy is recommended by the International Society for Clinical Densitometry 1.
- Use of biochemical markers of bone turnover to monitor response to therapy is not recommended 1.
- Screening for and intervention to prevent/treat diabetes and cardiovascular disease are recommended in men receiving ADT 1.
Important Notes
- Patients and their medical providers should be advised about the risks of ADT, including osteoporosis, prior to treatment 1.
- Fracture risk can be assessed using FRAX, the algorithm recently released by WHO, considering ADT as “secondary osteoporosis” 1.
From the Research
Procedure for Ordering Alendronate (Fosamax)
There are no research papers to assist in answering this question, as the provided studies do not mention Alendronate (Fosamax) or its ordering procedure.
- The studies focus on constipation treatment and management in various settings, including intensive care units and general adult populations 2, 3, 4, 5.
- One study discusses the administration and monitoring of high-alert medications in acute care, but does not specifically mention Alendronate (Fosamax) 6.
- None of the studies provide information on the proper procedure for ordering Alendronate (Fosamax).