Osteoporosis weakens bones by decreasing bone density. As bones become more porous, they weaken and grow brittle, often resulting in fractures. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), osteoporosis is the cause of more than 1.5 million bone fractures in the United States each year. Several medications are available to slow bone loss and increase density.
Biphosphonates
Biphosphonates, sold under the brand names Bonita, Fosamax and Actonel, work to slow the breakdown of bone, increase density and preserve existing bone. The drugs are approved for use by both men and women and are also helpful in treating osteoporosis caused by long-term steroid treatment. Potential side effects include abdominal pain, difficulty swallowing, nausea and an increased risk of gastric ulcers. According to NIAMS, there have been some rare cases of visual disturbances or osteonecrosis of the jaw following treatment with biphosphonates. Osteonecrosis is a condition in which bone tissue dies due to loss of blood supply. If you are taking biphosphonates, inform your dentist before you have any dental procedures performed.
Estrogen Therapy
Estrogen/hormone therapy (ET/HT) is used to prevent postmenopausal osteoporosis in women and is available in pills, creams, vaginal rings and patches. Because ET/HT does increase the risk of developing cancer of the uterine lining, it is usually recommended only if other treatments aren't effective. The medication combines the hormone progestin with estrogen in order to lower the risk of cancer in postmenopausal women who have not had a hysterectomy. Possible side effects include mood disturbances, blood clots, vaginal bleeding, gallbladder problems and tender breasts.
Raloxifene
Raloxifene, sold under the brand name Evista, works by mimicking the positive effects of estrogen on bone density in women who have reached menopause. This medication does not increase the risk of some cancers, as estrogen does. Side effects include blood clots and hot flashes. Raloxifene is approved for use by women only.
Teriparatide
Teriparatide, sold under the brand name Forteo, is a form of the human parathyroid hormone approved for both postmenopausal women and men at high risk for fractures. The drug is injected once each day under the skin in the abdomen or thigh and is used to stimulate new bone formation. Potential side effects include leg cramps, dizziness and nausea. The drug is particularly powerful and may be used for up to two years.
Calcitonin
Calcitonin, sold under the brand names Miacalcin and Fortical, is made from a natural hormone that is responsible for bone metabolism and regulation of calcium. Women who are at least five years past menopause may use the drug, which may be helpful in slowing bone loss, reducing bone resorption and preventing spinal fractures. Calcitonin is available as a nasal spray or in an injectable form. Side effects may include irritation of nasal passages, flushing of the hands and face, skin rash, nausea or frequent urination.
Zoledronic Acid
Zoledronic acid, sold under the brand name Reclast, is used to treat or prevent osteoporosis in women, increase bone mass in men who have the condition, and prevent new fractures in people who have had a hip fracture. It is also used to treat osteoporosis that occurs as a result of long-term steroid treatment. Zoledronic acid is available in intravenous (IV) form only. Patients are given this IV treatment every year to treat osteoporosis or every other year to prevent osteoporosis. Treatment takes about 15 minutes in a doctor's office. Pre-treatment blood tests are necessary to confirm that calcium and kidney function are at normal levels. Possible side effects include fever, headache, bone or joint pain, flu-like symptoms, low-blood calcium level, muscle pain or asthma symptoms if you are sensitive to aspirin.
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