These days there are many drug treatments available for osteoporosis. The different options can be confusing even if you are under the care of an excellent physician. Many of us want to be active in our treatment planning. This easy guide will give you an overview of osteoporosis drug therapies. Some of these drugs are prescribed to both osteoporosis patients and people with a low bone density condition called “osteopenia”.
Knowing how bones work is a key to understanding osteoporosis medications. Bones cells are constantly breaking down and being replaced by new cells. Bone-forming cells are called “osteoblasts” and bone-destroying cells are called “osteoclasts”. When we have osteoporosis, bone breakdown is faster than bone growth. Medications help turn this process around by slowing bone breakdown or promoting bone growth.
There are two types of osteoporosis medications: antiresorptive drugs and anabolic drugs. Antiresorptive drugs slow down the process of bone breakdown. An anabolic drug increases the rate of bone growth. The only drug to be approved in the anabolic category is Teriparatide.
Following is a brief introduction to osteoporosis medications:
- BISPHOSPHONATES: Drugs in this category include Alendronate Sodium (Fosamax®), Ibandronate Sodium (Bonival®), Risedronate Sodium (Actonel®), and Zoledronic Acid (Reclast®). These drugs are used for prevention and treatment. They slow bone breakdown by attaching to bone surfaces. These drugs are prescribed to post-menopausal women, men, and people taking steroid medications.
SERMs: SERMs stands for “Selective Estrogen Receptor Modulators”. Raloxifene (Evista®) is a SERM that is prescribed to postmenopausal women for osteoporosis treatment and prevention. Raloxifene acts like estrogen in maintaining bone density and reducing the risk of spinal fractures. It provides some of the positive effects of estrogen without some of the negative side effects, such as risk of breast cancer.
- HORMONE THERAPY (HT): There are many brands of estrogen/progesterone therapy, commonly prescribed to relieve symptoms of menopause. HT is used to treat or prevent osteoporosis in postmenopausal women. HT slows bone breakdown by increasing estrogen levels.
- CALCITONIN: Drugs in this category include Fortical® and Miacalcin®. Calcitonin is a hormone made by the thyroid gland that controls bone destroyer cells. It slows bone loss and helps prevent spinal fractures. It is prescribed only to persons with osteoporosis, usually to women who are at least five years beyond menopause.
- TERIPARATIDE: Teriparatide (Forteio®) is the only bone-forming medication. It is a type of parathyroid hormone, prescribed to men and postmenopausal women with at high fracture risk. Your risk of fracture is considered high when you have a recent fracture and your bone density T-score is less than -3.0. Teriparatide cannot be taken for more than 18 to 24 months.
Use this guide to do further research and to help you ask questions. Having an overview of prescription medications will help you to understand your doctor’s recommendations. Choosing the right treatment is a process. You may have to try different drugs and dosages before you find the best approach for you.