FAQs About Osteoporosis
How is osteoporosis treated?
The measures you take to keep bones healthy and prevent osteoporosis – such as exercising and consuming enough calcium and vitamin D – are also important for the treatment of osteoporosis. But if you have the disease, you will also need medication to improve bone density or to help keep bone loss from progressing. There are a number of different types of medication approved for treating osteoporosis. Some of these medications are taken orally, some are injected and one is available as a nasal spray. They are:
Bisphosphonates. This class of medications includes alendronate (Fosamax), ibandronate (Boniva), risedronate (Actonel) and zoledronic acid (Reclast). These drugs work by slowing bone loss. When bone loss is slowed and you continue to make new bone at a normal pace, bone density may actually improve. Alendronate and risedronate are taken orally daily or weekly. Ibandronate is taken orally monthly or intravenously once every three months, Zoledronic acid is administered intravenously once a year. Alendronate and risedronate are approved by the FDA for both men and women.
Calcitonin. Calcitonin (Fortical, Miacalcin) is a daily hormonal treatment available by nasal spray or injection. It is approved only for women. Like bisphosphonates, calcitonin works by slowing bone loss.
Hormone replacement therapy (HRT). HRT is a treatment to replace the hormones (estrogen alone or estrogen plus progestin) women lose after menopause. Replacing the natural hormones has been shown to reduce bone loss, but it is also associated with serious side effects, including increased risk of breast cancer and cardiovascular disease. It is not as commonly prescribed as it once was, and the FDA advises nonestrogen alternatives for osteoporosis. HRT is approved only for postmenopausal women.
Selective estrogen receptor modulators (SERMs). SERMs were developed to provide the benefits of HRT without the risks. At this time, only one SERM – raloxifene (Evista) – is approved for osteoporosis, but others are in development. Raloxifene is a daily oral medication. SERMS are approved only for women.
Bone-formation agents. At present, only one bone-formation agent – teriparatide (Forteo) – has been approved for osteoporosis. It is taken daily by injection. Unlike other osteoporosis drugs, which slow bone loss, teriparatide builds bone. It is approved for both men and women.
