Men's Osteoporosis Support Group

Fosamax and atrial fibrillation

Arch Intern Med. 2008;168(8):826-831. Vol. 168 No. 8, April 28, 2008. Use of Alendronate and Risk of Incident Atrial Fibrillation in Women, Heckbert SR and others. This study involved 719 women with confirmed incident atrial fibrillation (AF) who were compared to similar control women without AF. The authors found, "Based on the population-attributable fraction, we estimated that 3% of incident AF in this population might be explained by alendronate use."

Editor's comments: There is also a USA Today online article about this study. It appears that the risk of AF, if indeed there is one from taking Fosamax (alendronate), that risk is there if you are currently taking the medication or have ever taken it. Thus, if you are concerned by the risk of AF, it would appear to do no good to stop taking the Fosamax. This is confirmed in the USA Today article by Dr. Ethel Siris, the president of the National Osteoporosis Foundation. There are many studies involving people taking Fosamax, and other bisphosphonates for osteoporosis. To this point, the Heckbert and others study is only the third one with any indication of a bisphosphonate causing AF, and the link the other two studies was questionable. I discussed the other two articles in a recent Update regarding Once-yearly zoledronic acid to treat osteoporosis. None of these studies involved men, so it would be complete conjecture at this point to include men in the at-risk group. The bottom line is that there may be a slightly increased risk for AF in people taking bisphosphonates for osteoporosis. If so, the AF does not appear to be life-threatening, and thus shouldn't be of great concern. The risk of a serious fracture is probably of much more concern, and thus reason to continue taking your bisphosphonate. Discuss this with your physician if you are in doubt.

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