In addition to lifestyle changes—such as performing weight-bearing exercises and making sure you’re getting in enough calcium—prescription medications can help treat osteoporosis by slowing down bone loss and in some cases helping to rebuild bone. The right medication will depend on a range of factors, including your gender and personal health history.
Bisphosphonates are medications prescribed by a healthcare provider to help preserve bone mass, increase bone density in the hip and spine, and reduce the risk of fractures.There are several different types of bisphosphonates. This class of drugs includes:
- alendronate (Fosamax)—this is an oral medication this is typically taken weekly
- ibandronate (Boniva)—this can be taken as a monthly oral tablet or as an intravenous injections four times a year
- risedronate (Actonel)—the medication is available in daily, weekly, twice monthly, or monthly forms
- zoledronic acid (Reclast)—the drug is given intravenously once every year or two years
Side effects may include nausea, stomach pain, and digestive problems. There have been reports of permanent bone damage of the jaw bones (called jaw osteonecrosis) with high doses of intravenous and oral forms of bisphosphonates.
Calcitonin is a hormone made by the thyroid gland. It works by preventing bone break down and may help slow down bone loss in the spine (but not the hip). Calcitonin is generally considered a second or third line agent that is used only if a patient is not able to tolerate bisphosphonates. The intranasal form has been found to be effective at treating the pain of acute vertebral fractures. Brand names include Fortical and Miacalcin.
Selective Estrogen Receptor Modulators (SERMs)
Selective estrogen receptor modulators mimic the effect of estrogen on the bone tissue and help to stop the breakdown of bone and increase bone density. One example of an SERM is raloxifene (Evista), an oral daily tablet.
This drug is administered as a daily injection stimulate new bone growth, rather than simply slow down bone breakdown. An example of parathyroid hormone medication includes teriparatide (Forteo). Teriparatide is the only agent for osteoporosis that actively stimulates new bone formation rather than just preventing excess bone resoprtion. This drug is very expensive and is generally reserved for people with severe osteoporosis or those who have not had success with bisphosphonates.