A 60-year-old woman is in the clinic for an annual well-woman examination. She has been taking alendronate (Fosamax) 10 mg daily for 4 years. Her last bone density test yielded a T-score of 2.0 . Her urine NTx level today is 22 . She walks daily
Her fracture risk is low. The primary care NP should recommend that she: a. take a 1- to 2-year drug holiday.
b. change to 70 mg of alendronate weekly.
c. decrease the alendronate dose to 5 mg daily.
d. change to ibandronate (Boniva) 3 mg IV every 3 months.
A
The American Association of Clinical Endocrinologists recommends patients have a "drug holiday" after 4 to 5 years of bisphosphonate treatment if osteoporosis is mild and the fracture risk is low. The other options are all viable treatment regimens but are not appropriate in this case.
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