Fosamax and Jaw Injury Claims: What the Court Record Shows

Fosamax (alendronate sodium) is a prescription bisphosphonate used to treat and prevent osteoporosis. Its current prescribing information warns that osteonecrosis of the jaw has been reported in patients taking bisphosphonates, including Fosamax. Federal lawsuits alleging that Fosamax caused jaw injuries were consolidated as MDL No. 1789 in the Southern District of New York in 2006. The Fosamax docket still active in the Judicial Panel’s October 1, 2026 statistics is MDL No. 2243 in the District of New Jersey, which concerns atypical femoral fractures. The Panel counts 559 actions pending there of 1,294 filed. No court in the documents reviewed here has found that Fosamax caused any individual’s osteonecrosis of the jaw.

What is established versus what is alleged

The current label establishes that the manufacturer warns about osteonecrosis of the jaw. The Panel’s transfer orders establish the two dockets’ dates, courts and initial scope, and its October 1, 2026 report establishes the pending count.

What remains alleged is that Fosamax caused osteonecrosis of the jaw in any individual, that Merck’s warnings were inadequate, that the drug was defectively designed, and that any plaintiff is entitled to compensation. A verdict in one bellwether case decides that case. It does not bind other plaintiffs or establish causation for anyone else.

What the FDA label says about the jaw

The FOSAMAX prescribing information, revised February 2026, addresses osteonecrosis of the jaw in section 5.4. It states that the condition “can occur spontaneously, is generally associated with tooth extraction and/or local infection with delayed healing, and has been reported in patients taking bisphosphonates, including FOSAMAX.”

The section lists risk factors: invasive dental procedures, cancer, certain concomitant therapies, poor oral hygiene, and pre-existing dental disease or infection. It states that risk may increase with duration of exposure, that discontinuing bisphosphonate treatment may reduce the risk for patients who need invasive dental procedures, and that patients who develop the condition should receive care by an oral surgeon.

A label warning is a regulatory action. It is not a judicial finding that the drug caused any person’s injury.

The jaw litigation and the Boles verdict

The Panel created MDL No. 1789 on August 16, 2006, centralizing 18 actions before Judge John F. Keenan in the Southern District of New York. The order identified Merck’s knowledge of the drug’s alleged adverse effects, “in particular, osteonecrosis of the jaw,” as a common factual question.

The first bellwether was Boles v. Merck. The first trial began August 11, 2009 and ended in a mistrial on September 11, 2009. The retrial produced an $8 million verdict for the plaintiff on June 25, 2010 on strict liability design defect and negligent design claims. On October 4, 2010, the court denied Merck’s motions for judgment as a matter of law and a new trial, but reduced the award to $1.5 million, with the plaintiff choosing between that amount and a new trial on damages.

A later bellwether, Scheinberg v. Merck, produced a mixed ruling on January 7, 2013. The court granted Merck summary judgment on warranty, fraud, concealment and punitive damages claims but denied it on design defect and failure to warn. It did not find that Fosamax caused the plaintiff’s condition.

MDL No. 1789 does not appear among the active dockets in the Panel’s October 1, 2026 report. The report lists only MDL No. 2243 as an active Fosamax docket.

The active Fosamax docket concerns thigh fractures

The Panel created MDL No. 2243 on May 23, 2011. The order covered 36 actions in eight districts and assigned them to the District of New Jersey before Judge Garrett E. Brown, Jr. It described common questions arising from allegations that Fosamax or its generic equivalent caused femur fractures or similar bone injuries. The October 1, 2026 report lists Judge Karen M. Williams as the district judge and counts 559 actions pending of 1,294 filed.

The bellwether was Glynn v. Merck Sharp & Dohme. The jury trial ran from April 8 to April 29, 2013. On April 29, 2013, the jury returned a verdict for Merck, finding that the plaintiff did not prove she experienced an atypical femoral fracture in April 2009. The court then granted Merck’s preemption motion.

The Third Circuit vacated that ruling on March 22, 2017, holding that Merck had not carried its burden. The Supreme Court vacated and remanded in Merck Sharp & Dohme Corp. v. Albrecht in 2019, holding that the preemption question is for a judge, not a jury. On remand, the district court again granted summary judgment for Merck. The Third Circuit vacated that judgment on September 20, 2024 and remanded.

This appellate history concerns atypical femoral fractures, not jaw injuries.

Key dates

• August 16, 2006: the Panel creates MDL No. 1789 for Fosamax jaw claims before Judge Keenan.
• June 25, 2010: the Boles retrial jury returns an $8 million verdict on design defect and negligent design claims.
• October 4, 2010: the court reduces the Boles award to $1.5 million.
• May 23, 2011: the Panel creates MDL No. 2243 for femur fracture claims before Judge Brown.
• January 7, 2013: the Scheinberg court denies summary judgment on design defect and failure to warn.
• April 29, 2013: the Glynn jury returns a verdict for Merck; the court then grants summary judgment on preemption.
• March 22, 2017: the Third Circuit vacates the preemption ruling and remands.
• 2019: the Supreme Court vacates the Third Circuit’s judgment in Merck Sharp & Dohme Corp. v. Albrecht and remands.
• September 20, 2024: the Third Circuit vacates the district court’s summary judgment for Merck and remands.
• February 2026: the current Fosamax prescribing information is revised, including section 5.4.
• October 1, 2026: the Panel reports 559 actions pending of 1,294 filed in MDL No. 2243.

What this does not establish

Nothing in the reviewed documents shows a court finding that Fosamax caused any individual’s osteonecrosis of the jaw, that Merck’s warning was inadequate, or that any plaintiff is entitled to compensation. The Boles verdict was one jury’s decision, and the court reduced the award.

The record contains no court-approved global settlement of the jaw claims and no final appellate ruling on their merits. MDL No. 1789’s absence from the active-docket report does not show how each action ended. A pending count measures open dockets, not merit.

Frequently asked questions

Are the Fosamax jaw claims part of MDL No. 2243?

No. MDL No. 2243 is the atypical femoral fracture docket. The jaw claims were consolidated in MDL No. 1789 in the Southern District of New York in 2006, and the Panel’s October 1, 2026 report does not list MDL No. 1789.

Did a jury award damages for osteonecrosis of the jaw?

Yes, in Boles v. Merck. A jury returned an $8 million verdict on June 25, 2010 on design defect and negligent design claims. The court reduced the award to $1.5 million on October 4, 2010. That was one case, not a class-wide determination.

What does the current Fosamax label say about osteonecrosis of the jaw?

Section 5.4 states that osteonecrosis of the jaw has been reported in patients taking bisphosphonates, including Fosamax. It lists risk factors including invasive dental procedures, cancer, certain concomitant therapies, poor oral hygiene and pre-existing dental disease. It is a regulatory warning, not a causation finding.

Is there a settlement in the Fosamax jaw litigation?

The documents reviewed for this article contain no court-approved global settlement of the jaw claims. The Boles case ended in a remitted verdict. MDL No. 2243 remains active on the Panel’s October 1, 2026 report.

What is the current status of MDL No. 2243?

The Panel counts 559 actions pending of 1,294 filed as of October 1, 2026. The Third Circuit’s September 20, 2024 opinion vacated the district court’s summary judgment for Merck and remanded. The docket concerns atypical femoral fractures, not jaw injuries.

Background on how these proceedings differ from a class action appears in the guide to MDLs and class actions. The pharmaceutical lawsuits hub collects related coverage, including the proton pump inhibitor litigation, the Elmiron vision injury litigation and the Depo-Provera meningioma litigation.

Sources

1. U.S. Judicial Panel on Multidistrict Litigation: “MDL Statistics Report: Distribution of Pending MDL Dockets by Actions Pending, Report Date 10/1/2026” (link, accessed 2026-10-19)
2. U.S. Judicial Panel on Multidistrict Litigation: “Transfer Order, In re: Fosamax Products Liability Litigation, MDL No. 1789 (J.P.M.L. August 16, 2006)” (link, accessed 2026-10-19)
3. U.S. Judicial Panel on Multidistrict Litigation: “Transfer Order, In re: Fosamax (Alendronate Sodium) Products Liability Litigation (No. II), MDL No. 2243 (J.P.M.L. May 23, 2011)” (link, accessed 2026-10-19)
4. U.S. District Court for the Southern District of New York: “Boles v. Merck & Co., No. 06 Civ. 9455, 742 F. Supp. 2d 460 (S.D.N.Y. October 4, 2010)” (link, accessed 2026-10-19)
5. U.S. District Court for the Southern District of New York: “Scheinberg v. Merck & Co., 924 F. Supp. 2d 477 (S.D.N.Y. January 7, 2013)” (link, accessed 2026-10-19)
6. U.S. District Court for the District of New Jersey: “Glynn v. Merck Sharp & Dohme Corp., 951 F. Supp. 2d 695 (D.N.J. 2013)” (link, accessed 2026-10-19)
7. U.S. Court of Appeals for the Third Circuit: “In re: Fosamax (Alendronate Sodium) Products Liability Litigation, 852 F.3d 268 (3d Cir. March 22, 2017)” (link, accessed 2026-10-19)
8. Supreme Court of the United States: “Merck Sharp & Dohme Corp. v. Albrecht, 587 U.S. 299 (2019)” (link, accessed 2026-10-19)
9. U.S. Court of Appeals for the Third Circuit: “In re: Fosamax (Alendronate Sodium) Products Liability Litigation, No. 22-3412 (3d Cir. September 20, 2024)” (link, accessed 2026-10-19)
10. National Library of Medicine, DailyMed: “FOSAMAX (alendronate sodium) tablets, prescribing information (revised February 2026)” (link, accessed 2026-10-19)

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