Types of Medication for Osteoporosis

Our bones undergo constant renovation, wherein the osteoclasts break down to remove old bone, and then osteoblasts (cells) form new cells. With age, especially after menopause for women, the rate of bone formation doesn’t keep pace with that of bone, leading to bone density loss (osteoporosis).

The doctor determines bone density using dual-energy X-ray absorptiometry. The result is expressed as a number called T-score. A T-score lower than 2.5 indicates the presence of osteoporosis.

There is no cure for osteoporosis; however, with medicine and lifestyle changes, one can manage the symptoms of osteoporosis.

Some of the commonly prescribed medications include:

1. Bisphosphonates: It is the drug of choice for the treatment of osteoporosis. Due to the side effects, other alternatives were developed. These drugs strengthen the bones by impairing the rate of bone removal by osteoclasts.
   • Some examples include:
     • Alendronate
     • Ibandronate
     • Risedronate
     • Zoledronic acid
2. Hormone-related medications: Several medications with hormone-like effect work by either inhibiting bone removal or accelerating the rate of new bone formation or doing both. Most hormones have been restricted by the FDA due to their side effect profile and should be used when other therapies don’t work.
   • Some examples include:
     • Calcitonin
     • Parathyroid hormone
     • Estrogens
3. Monoclonal antibodies: These drugs prevent the development of bone-removing osteoclasts.
   • Some examples include:
     • Denosumab
     • Romosumab

Bisphosphonates have been widely prescribed for treating osteoporosis. When bisphosphonates fail, your physician may turn to other drugs.

Common side effects of bisphosphonates include:

• Nausea
• Heartburn
• Stomach pain

Common side effects of hormone-related medications include:

• Dizziness
• Headaches
• Nausea
• Leg cramps
• Allergic reactions

Common side effects of monoclonal antibodies include:

• Low blood calcium
• Skin infections
• Rash

This is not a complete list of side effects and other serious side effects or health problems that may occur because of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to the FDA at 1-800-FDA-1088.

Some drugs such as bisphosphonates are completely contraindicated during pregnancy as they can pose the risk of birth defects in the fetus.

Other drugs should be used only if the benefits outweigh the risk during pregnancy as animal studies report that there is a risk to the developing fetus.

Consult your doctor about the safest drug during pregnancy.

Although there are no known interactions between osteoporosis medication and alcohol, it is better to check with your doctor before combining the two. Some studies have reported that excessive alcohol consumption can increase the risk of osteoporosis, bone fracture, or impaired healing after a fracture. Moderate drinking is acceptable but confirms with your doctor about the limit.