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Medicines for osteoporosis

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

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Osteoporosis

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Description

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

When are Medicines Used?

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

Your doctor may prescribe medicines when:

Bisphosphonates

Bisphosphonates are the main medicines 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. You also may get bisphosphonates through a vein (IV). Most often this is done once or twice a year.

Common side effects with bisphosphonates taken by mouth are heartburn, nausea, and pain in the belly. When you take bisphosphonates:

Rare side effects 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.

Other Drugs for Osteoporosis

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

Denosumab (Prolia) is a medicine that prevents bones from becoming more fragile. This medicine:

Teriparatide (Forteo) is a bio-engineered form of parathyroid hormone. This medicine:

Estrogen, or hormone replacement therapy (HRT). This medicine:

Romosuzomab (Evenity) targets a hormone pathway in bone called sclerostin. This medicine:

These medicines are rarely used for osteoporosis or only for specific situations:

Parathyroid hormone

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

When to Call the Doctor

Call your doctor for these symptoms or side effects:

References

De Paula FJA, Black DM, Rosen CJ. Osteoporosis: basic and clinical aspects. In: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ , eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 30.

Eastell R, Rosen CJ, Black DM, Cheung AM, Murad MH, Shoback D. Pharmacological management of osteoporosis in postmenopausal women: an Endocrine Society* Clinical Practice Guideline. J Clin Endocrinol Metab. 2019;104(5):1595-1622. PMID: 30907953 pubmed.ncbi.nlm.nih.gov/30907953/.

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Review Date: 5/13/2020  

Reviewed By: Brent Wisse, MD, board certified in Metabolism/Endocrinology, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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