DM has been prescribed Alendronic Acid and is really struggling

[EagleRay]

DM is 77 and has been in reasonably good health (is at the docs a lot for various things and has a bit of a loss of confidence but hasn't had any major illnesses that I can recall)

Earlier this year she fell when out walking and broke a bone in her arm/wrist. It took a long time to heal and get back to normal as she had to do lots of work to get function back in her hand once it was out of plaster. It's the first broken bone she's ever had.

She's now been prescribed Alendronic Acid and after the first dose yesterday suffered debilitating side effects (headache, frozen face, reflux etc) and she feels very distressed/depressed as a result and can't face taking any more. She suffers from acid reflux problems anyway and this hasn't helped!

Thing is, her GP won't do a bone scan and the osteoporosis diagnosis seems to be on the basis of the bone break. GP also won't prescribe any alternatives as, like the bone scan, it costs too much.

I don't know much about the drug but it seems it shouldn't be prescribed lightly. Is it a case of using a sledgehammer to crack a walnut?

Would it be reasonable to insist on a bone scan? Is it something we could do privately?

I'm just trying to work out if the best decision has been made for her and what we can do about alternatives!

Have you looked at the National Osteoporosis Society (NOS) website? They will have info about alternatives including risedronate. Same type of drug (bisphosphonate) as alendronic acid but different side effect profile (less acid reflux, no need to stay upright after taking etc)

Thanks - I actually found out about the existence of the org after my original post so will look there next.

Problem is, the GP has already said there are no alternatives due to cost!

The national guidance is that if >75 and a low trauma fracture it will be osteoporosis and thus scans aren’t available for women aged >75.

This may be the first line approach due to cost, but if your mum is having side effects these need to be reported to the doctor and/or the drug company, and then your mum should be offered an alternative (which definitely exists). Ask the NOS for advice, they're v good.

My GP prescribed risedronate, no questions asked, because I'm prone to a dodgy tummy. You still have to stay upright after taking it though. I then fractured a vertebrae and now have zolendronate annually. I'm 58.

I think your mum needs to be her own advocate here. Risedronate isn't much more expensive than alendronate and will be much cheaper for the nhs if she breaks a hip due to not taking anything.

A private referral is probably worth it so the consultant recommends the optimum treatment for your mum. Referral and dexa scan I imagine will be about £750. If your mum doesn't have osteoporosis she doesn't need a bisphosphonate.

Money is a big issue for them - I think a scan on its own would be affordable but not a full private consultation.

I'll get onto the NOS tomorrow to see what they advise. I don't live nearby and so it's hard to help with advocating. And I don't think DM has confidence to speak up or assert herself

Thank you everyone for replying

I've just been diagnosed and started alendrinic acid. The Royal society spoke to me today and said risedronste may be gentler on your tummy. Have you had sick effects with this or OK?