Navigate Up

Women's Center - A-Z Index


Print This Page

Medicines for osteoporosis

Osteoporosis is a disease that causes bones to become brittle and more likely to fracture (break). With osteoporosis, the bones lose density. Bone density measures the amount of bone tissue that is in your bones.

A diagnosis of osteoporosis means you are at risk of bone fractures even if you do not have a severe bone injury.

Alternative names

Alendronate (Fosamax); Ibandronate (Boniva); Risedronate (Actonel); Zoledronic acid (Reclast); Raloxifene (Evista); Teriparatide (Forteo); Denosumab (Prolia); Low bone density - medicines; Osteoporosis - medicines

When are medicines used?

Your doctor may prescribe medicines to help lower your risk of fractures. These medicines make the bones in your hips, spine, and other areas denser.

Your doctor is more likely to prescribe medicines if:

  • A bone density test shows you have osteoporosis, even if you do not have a fracture.
  • You have a bone fracture, and a bone density test shows you have thinner than normal bones, but not osteoporosis.
  • You have a bone fracture that occurs without any significant injury.


Bisphosphonates are the main drugs that are used to both prevent and treat bone loss. They are most often taken by mouth. You may take a pill either once a week or once a month.

Common side effects of bisphosphonates are heartburn, nausea, and pain in the belly. When you take bisphosphonates:

  • Take them on an empty stomach in the morning with 6 to 8 ounces of plain water (not carbonated water or juice).
  • After taking the pill, remain sitting or standing for at least 30 minutes.
  • Do not eat or drink for at least 30 to 60 minutes.

Less common side effects of bisphosphonates are:

  • Low blood calcium level
  • A certain type of leg-bone fracture
  • Damage to the jaw bone
  • Fast, abnormal heart beat (atrial fibrillation)

Your doctor may have you stop taking this medicine after about 5 years. Doing so decreases the risk of certain side effects. This is called a drug holiday.

You also may get bisphosphonates through a vein (IV). Most often this is done once a year.

Other drugs for osteoporosis

If you are at high risk of fractures, your doctor may ask you to take parathyroid hormone.

  • This medicine is given through daily shots under the skin. Your doctor or nurse will teach you how to give yourself these shots at home.
  • Parathyroid hormone works better if you have never taken bisphosphonates.

Calcitonin is a medicine that slows the rate of bone loss. This medicine:

  • Is sometimes used after a bone fracture because it decreases bone pain
  • Is less effective than bisphosphonates
  • Comes as a nasal spray or an injection

Raloxifene (Evista) may also be used to prevent and treat osteoporosis.

  • It can reduce the risk of spinal fractures, but not other types of fractures.
  • The most serious side effect is a very small risk of blood clots in the leg veins or in the lungs .
  • This drug may also help decrease the risk of heart disease and breast cancer.

Denosumab (Prolia) is a medicine that slows weakening of bones. This medicine:

  • Is give as an injection every 6 months
  • May increase bone density more than bisphosphonates
  • Does not cause stomach upset compared with other medicines taken by mouth
  • May not be a good choice for persons who have weak immune systems or who take medicines that affect the immune system

For a time, estrogen and hormone replacement therapy (HRT) were frequently used to prevent osteoporosis. But they are rarely used for this purpose now. If a woman is taking estrogen already, she and her doctor must discuss the risks and benefits of doing so.

When to call your doctor

Call your doctor for these symptoms or side effects:

  • Chest pain, heartburn, or problems swallowing
  • Nausea and vomiting
  • Blood in your stool
  • Swelling, pain, redness in one of your legs
  • Fast heart beat
  • Skin rash


Lewiecki EM. In the clinic. Osteoporosis. Ann Intern Med. 2011 Jul 5;155(1):ITC1-1-15; quiz ITC1-16.

Park-Wyllie LY, Mamdani MM, Juurlink DN, Hawker GA, Gunraj N, Austin PC, et al. Bisphosphonate use and the risk of subtrochanteric or femoral shaft fractures in older women. JAMA. 2011 Feb 23;305(8):783-9.

National Osteoporosis Foundation. 2014 Clinician's Guide to Prevention and Treatment of Osteoporosis. April 1, 2014. Accessed on May 15, 2014.

Rosen C. Osteoporosis. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 251.

Updated: 5/15/2014

C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

©  UPMC | Affiliated with the University of Pittsburgh Schools of the Health Sciences
Supplemental content provided by A.D.A.M. Health Solutions. All rights reserved.

For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1.

UPMC is an equal opportunity employer. UPMC policy prohibits discrimination or harassment on the basis of race, color, religion, ancestry, national origin, age, sex, genetics, sexual orientation, gender identity, marital status, familial status, disability, veteran status, or any other legally protected group status. Further, UPMC will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in UPMC programs and activities. This commitment is made by UPMC in accordance with federal, state, and/or local laws and regulations.

Medical information made available on is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have. Further, is not a tool to be used in the case of an emergency. If an emergency arises, you should seek appropriate emergency medical services.

For UPMC Mercy Patients: As a Catholic hospital, UPMC Mercy abides by the Ethical and Religious Directives for Catholic Health Care Services, as determined by the United States Conference of Catholic Bishops. As such, UPMC Mercy neither endorses nor provides medical practices and/or procedures that contradict the moral teachings of the Roman Catholic Church.

Pittsburgh, PA, USA