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Osteoporosis Drugs

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Updated September 06, 2013

Using Osteoporosis Drugs:

Many people think of bone as a structure, like the frame of your house or the chassis of your car. But bone is a living tissue that is constantly changing. New bone is always being made, and old bone taken away. Osteoporosis develops when the rate of bone loss exceeds the rate of bone formation.

Treatment of osteoporosis focuses on trying to increase the rate of bone formation and decrease the rate of bone loss. This can be accomplished by different methods including exercising, stopping smoking, eating right, and taking medications.

Calcium:

Calcium is a mineral found most abundantly in our bones. Calcium is one of the building blocks of normal bone, yet many people do not ingest enough calcium to maintain healthy bone. With people living longer, this creates a significant problem if the bone loses its strength and become susceptible to fracture.

Everyone should consume calcium every day, and some people need to consume extra calcium in their diet. Calcium supplements can be taken if you do not ingest enough calcium in your normal diet. Also, there are non-dairy foods that contain calcium.

Vitamin D:

Vitamin D works together with calcium to help maintain normal bone health. Vitamin D is necessary for your body to absorb calcium; even if you are ingesting calcium, your body may not be able to absorb it if you don't also have enough vitamin D.

Children who do not get enough vitamin D have a condition called rickets, and adults who don't get enough vitamin D have a condition called osteomalacia.

Bisphosphontes:

Bisphosphonates are a type of medication known as antiresporptive medications. These medications prevent bone loss by inhibiting the normal function of cells called osteoclasts. These are the cells responsible for removing old bone. When osteoclasts are working harder than the cells making new bone, the development of osteoporosis can be accelerated.

Some of the commonly prescribed bisphosphonates include:

  • Fosamax
  • Boniva
  • Actonel
  • Reclast
Side effects of bisphosphonates include muscle and joint pain, nausea, and heartburn. A rare side effect called osteonecrosis of the jaw has also been seen.

Calcitonin:

Calcitonin is a hormone produced in your thyroid gland. Calcitonin is naturally made in your body when blood calcium levels are high. This tells your body to retain calcium within the skeleton, rather than use calcium in the bone to replenish the calcium in the bloodstream. Calcitonin works by limiting function of the osteoclast cells that consume bone to release calcium in the bloodstream.

Calcitonin is usually administered by a nasal spray. Side effects of calcitonin include runny nose, headaches and nose bleeds.

Hormone Therapy/Estrogen:

Estrogen therapy (ET) or hormone therapy (HT) are effective treatments for preventing bone loss and reducing risk of fracture. ET has been shown to cause an increased risk of uterine cancer, and is therefore used alone only in patients who have had a prior hysterectomy. In others, combination estrogen and progesterone treatment (HT) is used.

Concerns about increased risk of breast cancer, stroke, and blood clots have surrounded the use of these medications for osteoporosis. Therefore, the FDA recommends the use of ET/HT only if other medications cannot be used and there is a significant risk of osteoporosis.

Bone Forming Medications:

A new medication is being used to help the body make more bone. The medication called teriparatide (Forteo), is a synthetic version of parathyroid hormone. Parathyroid hormone is your body's internal signal to make more bone. Given by injection, teriparatide stimulates the body to increase the amount of bone formation.

Sources:

JM Lane and M Nydick "Osteoporosis: current modes of prevention and treatment" J. Am. Acad. Ortho. Surg., Jan 1999; 7: 19 - 31.

"Osteoporosis Medications" National Osteoporosis Foundation.

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