Alendronate (Fosamax); Ibandronate (Boniva); Risedronate (Actonel); Zoledronic acid (Reclast); Raloxifene (Evista); Teriparatide (Forteo); Denosumab (Prolia); Low bone density - medicines; Osteoporosis - medicines
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.
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:
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:
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.
If you are at high risk of fractures, your doctor may ask you to take parathyroid hormone.
Calcitonin is a medicine that slows the rate of bone loss. This medicine:
Raloxifene (Evista) may also be used to prevent and treat osteoporosis.
Denosumab (Prolia) is a medicine that slows weakening of bones. This medicine:
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.
Call your doctor for these symptoms or side effects:
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. http://nof.org/files/nof/public/content/file/2791/upload/919.pdf. 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 by: 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.
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