So, when should a woman be screened for potential bone loss? And how safe are the drugs for long-term use? In 2002, the U.S. Preventive Services Task Force, a panel of independent experts convened by the government's Agency for Healthcare Research and Quality, concluded that women 65 and older should be screened routinely for osteoporosis. Screening should begin at 60 for women at increased risk, which includes a family history of hip fractures, current smoking, thinness and use of steroids such as prednisone.
As for drug safety, a study published in March 2004 in the New England Journal of Medicine showed that Fosamax (alendronate) appears to be safe for as long as 10 years. But a 1998 study showed that although Fosamax helps prevent fractures in women with osteoporosis, it does not do so in women with osteopenia and no previous fractures.
Fosamax and Actonel can cause small ulcers in the esophagus, or food tube; Evista can cause hot flashes, and in rare cases, blood clots.
There is no evidence that the widespread use of Fosamax and Actonel is causing any problems, said Col of Rhode Island Hospital. But the drugs do get incorporated into bone. "If 10 years down the line, it turns out that something is dangerous, it will be sitting in a lot of people's bones. The benefits of treatment need to outweigh the risks."