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Paget's Disease (cont.)

How is Paget's disease diagnosed?

Paget's disease is diagnosed based on the X-ray appearance. Paget's disease might also be detected with other imaging tests, such as a bone scan, MRI scan, and CT scan. An enzyme that comes from bone called alkaline phosphatase is frequently elevated in the blood of people with Paget's disease as a result of the abnormal bone turnover of actively remodeling bone. This blood test is also referred to as the serum alkaline phosphatase (SAP).

The bone scan is particularly helpful in determining the extent of the involvement of Paget's disease as it provides visualization of the entire skeleton.

How is Paget's disease treated?

The treatment of Paget's disease is directed toward controlling the disease activity and managing its complications. When Paget's disease causes no symptoms and blood testing shows that the level of serum alkaline phosphatase is normal or minimally elevated, no treatment may be necessary. Bone pain can require antiinflammatory drugs (NSAIDs) or pain-relieving medications. Bone deformity can require supports such as heel lifts or specialized footwear. Surgical operations may be necessary for damaged joints, fractures, severely deformed bones, or when nerves are being pinched by enlarged bone. Prior to undergoing an operation on bone affected by Paget's disease, it is helpful to be treated with medications, such as bisphosphonates or calcitonin (Miacalcin), as this tends to diminish the risk of surgical complications, including bleeding.

The medical treatment of the bone of Paget's disease involves either medications called bisphosphonates or injectable calcitonin. Bisphosphonates are the mainstay of treatment. There are a number of these available that are taken by mouth, including alendronate (Fosamax), risedronate (Actonel), etidronate (Didronel), and tiludronate (Skelid), and that are administered intravenously, including pamidronate (Aredia) and zolendronate (Reclast). In general, oral bisphosphonates are taken first thing in the morning on an empty stomach with 8 ounces of water. They can cause irritation of the stomach and esophagus. Intravenous bisphosphonates can cause temporary muscle and joint pain.




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Paget's Disease - Symptoms

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INDICATION

Vivelle-Dot is used after menopause to: reduce moderate to severe hot flashes; treat moderate to severe dryness, itching and burning in or around the vagina; help reduce your chances of getting osteoporosis (thin weak bones); and treat certain conditions in which a young woman's ovaries do not produce enough estrogens naturally. Vivelle-Dot 0.025 mg/day is only used to prevent osteoporosis from menopause. If you use Vivelle-Dot only to treat your dryness, itching, and burning in and around your vagina or if you use Vivelle-Dot only to prevent osteoporosis from menopause, talk with your healthcare professional about whether a different treatment or medicine without estrogens might be better for you.

IMPORTANT SAFETY INFORMATION

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