Patient Education | Medications For Osteporosis

Alendronate (FOSAMAX) is approved by the FDA for the prevention and treatment of osteoporosis in postmenopausal women.   Controlled clinical trials indicate that over a 3-4 year period alendronate increases bone mass and reduces the incidence of fractures at the spine, hip and wrist by 50 percent.   It is also approved as a treatment for both women and men with osteoporosis as a result of prolonged steroid use (prednisone, cortisone).

Risedronate (ACTONEL) is approved by the FDA for the prevention and treatment of postmenopausal osteoporosis and is approved for the prevention and treatment of glucocorticoid-induced osteoporosis in men and women.   Risedronate has been demonstrated in studies to increase bone mass in the spin and hip and reduce the risk of spine and non-spine fractures by 40-50 percent over a 3-5 year period.

Side effects of both of these medications include upper gastrointestinal disorders and esophageal or gastric ulcer.   Both must be taken on an empty stomach, first thing in the morning with 8 ounces of water (no other liquid), at least 30 minutes before eating or drinking.   Patients should remain upright during this fasting interval.

Calcitonin (MIACALCIN) is FDA-approved for the treatment of osteoporosis in women who are at least 5 years postmenopausal.   It is delivered as a single daily intranasal spray.   Results from a single controlled clinical trial indicated that calcitonin may decrease osteoporotic vertebral fractures by approximately 35 percent but does not reduce the risk of non-spine fractures.

Calcitonin is generally considered to be a safe but somewhat less effective intervention for osteoporosis.   It may be used as an alternative to other agents for patients who meet the criteria for other osteoporosis treatments but aren't able to take them.

Raloxifene (EVISTA) is a selective estrogen receptor modulator, a class of drugs, which has been developed to provide the beneficial effects of estrogens without the potential disadvantage.   Raloxifene is approved by the FDA for both the prevention and treatment of osteoporosis in postmenopausal women.

Raloxifene provides modest increases in bone mass and reduces the risk of spinal fractures by 40-50 percent.   Data are not yet available to demonstrate that raloxifene can reduce the risk of non-vertebral fractures.   Raloxifene appears to decrease the risk of estrogen dependent breast cancer.   Preliminary data show that raloxifene may reduce heart disease and stroke in women at high risk or who already have heart disease.   Raloxifene increases the risk of deep vein thrombosis and can cause hot flashes.

It is important that if taking medication to improve bone density, that the requirements for   Calcium (500mg / 3 times daily) and Vitamin D (400IU / day) continue to be met for the medication to be effective.