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Osteoporosis Treatment: Medications Can Help

Osteoporosis treatment: Medication helps

Osteoporosis Treatment may involve medication and lifestyle changes. Get answers to some of the most frequently asked questions about osteoporosis treatment.

Mayo Clinic Staff

If you are being treated for osteoporosis, you are taking a step in the right direction for bone health. But maybe you have questions about your treatment. Are the medicines you are taking the best for you? How long do you need to take it? Why does your friend only take pills once a month while your doctor recommends taking them once a week?

Which osteoporosis medications are usually tried first?

    Bisphosphonates are often the drug of choice for the treatment of osteoporosis. These include:

      alendronate (Fosamax), One pill per week risedronate (Actonel) once a week or Monthly pill

    ibandronate (Boniva), once a month Pill or quarterly intravenous (IV) infusion

Zoledronic acid (Reclast ), yearly IV infusion

Another common osteoporosis drug is denosumab (Prolia, Xgeva). Independent of bisphosphonates, denosumab can be used in people who cannot take bisphosphonates, such as some people with reduced kidney function.

Denosumab is given by superficial injection, just under the skin, every six months. If you are taking denosumab, you may have to take it indefinitely unless your doctor switches you to another medicine. Recent studies have shown that the risk of spinal fractures is high after stopping the drug, so it’s important to keep taking it.

What are the common side effects of bisphosphonate pills?

    The main side effects of bisphosphonate pills are upset stomach and heartburn. Do not lie down or bend over for 30 to 60 minutes to prevent the medicine from flushing back up your esophagus. Most people who follow these tips do not experience these side effects.

    Bisphosphonate tablets are not well absorbed by the stomach. Taking the medicine with a large glass of water on an empty stomach may help. Do not put anything in your stomach for 30 to 60 minutes, after which you can eat, drink other fluids, and take other medicines.

    Are there advantages to intravenous bisphosphonates over pill form?

      Intravenous forms of bisphosphonates, such as ibandronate and zoledronic acid, do not cause stomach upset. For some people, scheduling a quarterly or yearly infusion may be easier than remembering to take their pills weekly or monthly.

      Intravenous bisphosphonates can cause mild flu-like symptoms in some people, but usually only after the first infusion. You can lessen this effect by taking acetaminophen (Tylenol, etc.) before and after your infusion.

      Are osteoporosis medications harming your bones?

        A very rare complication of bisphosphonates and denosumab is a break or crack in the middle of the thighbone. Known as an atypical femur fracture, this injury can cause mild pain at first in the thigh or groin and may gradually worsen. Jaw bone, a rare condition in which part of the jaw heals slowly or fails to heal, usually after tooth extraction or other invasive dental work. This condition is more common in patients with cancers that involve the bones — who take much higher doses of bisphosphonates than are usually used to treat osteoporosis.

        Should I take medical leave from bisphosphonates?

          The risk of developing atypical femur fractures or osteonecrosis of the jaw tends to increase the longer bisphosphonates are taken. Therefore, your doctor may advise you to temporarily stop taking this type of drug. This practice is known as a drug holiday.

          However, the positive effects persist even after you stop taking the drug. That’s because years after taking bisphosphonates, the drugs can linger in your bones.

          Due to this lingering effect, most experts believe it is reasonable for people who are doing during treatment – those who are not People with broken bones and maintaining bone density – consider taking a break from bisphosphonates after five years of taking them.

          Are hormones used to treat osteoporosis?

            Estrogens, sometimes paired with progestins, were once commonly used to treat osteoporosis. This treatment increases the risk of blood clots, endometrial cancer, breast cancer, and heart disease. It is now usually reserved for women at high fracture risk who cannot take other osteoporosis medications.

            Women who are considering hormone replacement therapy to reduce menopausal symptoms, such as hot flashes, may increase bone health when weighing the benefits and risks of estrogen therapy. The current recommendation is to use the lowest dose of the hormone for the shortest period of time.

            Raloxifene (Evista) mimics the beneficial effects of estrogen on bone density in postmenopausal women without some of the risks associated with estrogen. Taking this drug can reduce the risk of certain types of breast cancer. Hot flashes are a common side effect. Raloxifene may also increase your risk of blood clots.

            How do osteoporosis medications work?

              Throughout your life, healthy bones are constantly broken down and rebuilt. As we age — especially after menopause — bone breaks down faster. Bones deteriorate and become weaker as bone remodeling doesn’t keep pace.

              Most osteoporosis medicines work by slowing down the rate at which bone breaks down. Some work by speeding up the bone-building process. Both of these mechanisms strengthen bones and reduce the risk of fractures.

              Which medications help speed up the bone building process?

                Bone Medications include:

                  Teriparatide (Forteo)
                  Abaloparatide (Tymlos)

                Romosozumab (evening party)

            These types of medications are often indicated for very low bone density, previous fractures, or People with drug-induced osteoporosis.

            Teriparatide and abaloparatide require daily injections. Studies in laboratory mice have found an increased risk of bone cancer, so these drugs are not used in people at high risk of bone cancer. So far, no increase in bone cancer has been seen in people taking these drugs.

            Romosozumab is given as a monthly injection in your doctor’s office. It’s a new drug and little is known about long-term side effects, but it won’t be used in people who have had a recent stroke or heart attack. Treatment was stopped after 12 monthly doses.

            These bone-building drugs should only be taken for a year or two, and the benefits wear off quickly after you stop taking them. To protect the bone that’s already formed, you’ll need to start taking bone-stabilizing medications, such as bisphosphonates.

            Can medication alone be used successfully to treat osteoporosis?

              Do not rely solely on medication as the only treatment for osteoporosis. These practices are also important:

                  Exercise. Weight-bearing physical activity and exercises to improve balance and posture can strengthen bones and reduce fractures Opportunity. As you age, the more active and fit you are, the less likely you are to fall and break bones.

                good nutrition. Eat a healthy diet and make sure you get enough calcium and vitamin D.

              quit smoking. Smoking accelerates bone loss.

          Limit alcohol consumption. If you choose to drink alcohol, please do so in moderation. For healthy women, this means up to one drink per day. For healthy men, drink up to two glasses a day.

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