If you have
osteoporosis, you should work with your health care provider to plan a
treatment program that meets your needs. There are a variety of prescription
medications available to slow bone loss and help prevent fractures caused
by osteoporosis. The following medications are approved by the U.S. Food
and Drug Administration for prevention and/or treatment of osteoporosis.
The FDA can also provide information on approved medications.
bisphosphonates, Fosamax, Actonel,
and Boniva (brand names) are now available
to slow or stop bone loss and reduce fracture risk. They may be good
choices for women who can't, or won't, take HRT. Fosamax and Actonel
are available in once per week doses. To use bisphosphonates you must
follow strict rules and not lie down eat or drink for 30-60 minutes.
Some people find this inconvenient or have stomach pain using the medication.
Studies show that bisphosphonates reduces spinal fractures after just
one year of treatment. Boniva is the latest approved drug and is taken
once per month.
teriparatide (Forteo) has been shown to reduce the incidence of vertebral
fractures. It may be used when other drugs are considered unsuitable
and when there is a high risk of fractures.
or HRT, uses a combination of estrogen and other hormones to protect
women from bone loss. This treatment does increase bone density and
is low cost. Some studies show that long-term use may increase the risk
of breast cancer, but there may be a decreased risk of Alzheimer's disease.
or Miacalcin, is a hormone that
helps your body use calcium. It also seems to reduce bone loss and prevent
spine fractures. It is taken as a nasal spray so it is easy to use.
It has almost no side effects, but is considered less effective than
HRT or Fosamax.
estrogen receptor modulators (SERMs) like Raloxifene
is a medication developed to provide the benefits of estrogens without
some of their drawbacks. Raloxifene prevents bone loss like a low dose
of estrogen. It may increase the risk of blood clots and won't eliminate
hot flashes, but may reduce the risk of breast cancer.
additional prescription medications are under investigation.
details on the Women's Health Initiative and The National Institute of
Health July 2002 press release on HRT and risk of cardiovascular disease
and breast cancer at: http://www.nih.gov/news/pr/jul2002/nhlbi-09.htm.
The complete Journal of American Medical Association article about these
study results can be found at: http://jama.ama-assn.org/issues/v288n3/ffull/joc21036.html.
If you have
osteoporosis, or are at high risk for the disease, your health care provider
can help you plan a treatment program. They can help you decide what medications
would be the best choices for you, and review the benefits, side effects,
and how these medications interact with other medications you are taking
for other conditions. In addition to medicine, your treatment plan should
include a healthy, calcium-rich diet
and regular weight-bearing activity that promotes
healthy bones. Bone density
scans, completed before a treatment program starts, and repeated on
a regular basis, can help check whether the treatment program is working.
To get full
benefit from your prescription medications, it is important to take them
exactly as directed and for as long as your doctor prescribes.
Questions to ask your doctor
Your doctor will give you information about your condition, but you should
make sure that you clearly understand the benefits and risks of any treatment
he or she recommends. It may help to take a list of questions to your
appointment, and talk to your doctor about any concerns you have. Discuss
any problems you are having with treatment, and don't stop any medication
without talking to your doctor about it. You may wish to ask:
are the benefits of the treatment you recommend?
I notice any changes while taking the medication?
are the side effects of treatment?
should I do if I have any side effects?
changes can I make to my lifestyle to help lower my risk of fractures?
will happen if I don't have any treatment?
much do the treatments/tests cost?
should I return for another appointment?
long should I take the medication?
can I get more information about osteoporosis?
*Brand names are only provided as examples and not meant as endorsements.