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.
Alendronate (Fosamax); Ibandronate (Boniva); Risedronate (Actonel); Zoledronic acid (Reclast); Raloxifene (Evista); Teriparatide (Forteo); 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:
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 - 8 ounces of plain water (not carbonated water or juice).
Remain sitting or standing after taking the pill for at least 30 minutes.
Do not eat or drink for at least 30 - 60 minutes.
Less common side effects of bisphosphonates are:
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 for 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. It:
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.
Estrogen and hormone replacement therapy (HRT) were once often used to prevent osteoporosis, but they are rarely used anymore.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 health care provider 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
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. Clinician's Guide to Prevention and Treatment of Osteoporosis. Washington, DC: National Osteoporosis Foundation; 2010.
David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.