Bisphosphonates are the most common medications used for osteoporosis.
However, other types of medications are available, too.
This article reviews the factors that go into choosing an osteoporosis drug.
IndiaPix/IndiaPicture / Getty Images
A list of osteoporosis medications, including their mode of action and side effects, is also provided.
A summary chart that includes the drugs' common and serious side effects is also provided.
Bisphosphonates
Bisphosphonatesare the most commonly used drugs to treat osteoporosis.
Bisphosphonates work by slowing the natural breakdown of bone.
You then need to sit or stand upright for 30 minutes before eating.
Individuals who cannot follow these instructions or those with esophageal disorders should not take an oral bisphosphonate.
Bisphosphonates are generally taken for three to five years.
Terminology
Verywell Health prefers to use inclusive terminology.
But when citing health authorities or research, the terms for gender and sex from those sources are used.
Food and Drug Administration (FDA) guidelines for drug indications often use binary gender terms.
Talk to a healthcare provider to determine whether screening or a medication is indicated for you.
Proliais injected underneath the skin, usually by a healthcare provider, once every six months.
It works by blockinga protein involved in the formation of cells that break bone down (osteoclasts).
In addition, stopping Prolia is associated with rapid bone loss.
If the drug needs to be stopped, a bisphosphonate is usually prescribed to preserve bone density.
What Is a SERM?
Evista can slow down bone loss in postmenopausal females and is taken as a pill once a day.
As such, females at risk for stroke or blood clots should not take this medication.
Forteo and Tymlos work by stimulating bone formation.
Forteo and Tymlos are used for up to two years.
This restriction is due to the possible risk of developingosteosarcoma(a bang out of bone cancer).
Keep in mind, though, that osteosarcoma has only been seen in studies of animals, not humans.
Evenity enhances bone formation by blockingsclerostin, a protein that stops building new bone.
The drug can only be used for up to one year because it becomes less effective at reforming bone.
Also, Evenity may increase the risk ofheart attackandstroke, although it’s unclear why.
Which Osteoporosis Medication Is Safest?
Osteoporosis drugs have different risks and side effects profiles.
Despite being a “silent” disease, medication may be necessary to reduce your fracture risk.
Fractures can be devastating and are associated with a poor quality of life.
As you discuss osteoporosis treatment with your healthcare provider, the following factors will be taken into account.
In addition to menopause and declining estrogen levels, bones naturally weaken and thin with advancing age.
Overall, patient sex and age both influence the choice of therapy.
This is because some osteoporosis drugs are FDA-approved for both older males and postmenopausal females.
Other osteoporosis medications are only approved for postmenopausal females.
Likewise, some osteoporosis medications are better for younger postmenopausal females and others for older ones.
Extent of Bone Loss
The extent of your bone loss is reflected in yourT score.
You may not be able to tolerate certain drugs, or they may be unsafe for you to take.
Moreover, osteoporosis medications differ in their delivery method and dosing schedules.
You may prefer, for example, a pill vs. a shot or a monthly vs. daily medication.
Your healthcare provider can also refer you to a social worker or billing specialist for assistance.
Take an integrative approach, which includes healthy lifestyle behaviors and, sometimes, medication.
Treatment with medication is sometimes recommended to prevent bone breaks.
Several drugs are available, including bisphosphonates, estrogen-like medications, and parathyroid hormone.
These drugs vary in their modes of action, delivery method, dosing schedule, and side effects.
Such factors must be carefully considered when deciding on the right therapy for you.
2018;33(2):190-198. doi:10.1002/jbmr.3337
Food and Drug Administration.Evista labeling.
Food and Drug Administration.Highlights of prescribing information: Forteo (teriparatide injection).
Food and Drug Administration.FDA approves new treatment for osteoporosis in postmenopausal women at high risk of fracture.
2019;8(1):175-183. doi:10.1080/21556660.2019.1677674
Ji MX, Yu Q.
Primary osteoporosis in postmenopausal women.Chronic Dis Transl Med.
2016;41(3 Suppl):S27.
