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Treatments > Drug Guide > Types of Drugs > Drug Guide: Osteoporosis Medications
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Drug Guide: Osteoporosis Medications

What do osteoporosis treatments do?

Osteoporosis medications (bisphosphonates included) can increase bone density and reduce the risk of fractures over time. Most osteoporosis drugs do this only by slowing bone loss: Bisphosphonates – alendronate (Fosamax), ibandronate (Boniva), risedronate (Actonel) and zoledronic acid (Reclast); the hormone calcitonin; the estrogens; and the selective estrogen receptor modulator raloxifene (Evista). Only one osteoporosis drug – teriparatide (Forteo) – also promotes bone growth.

How is osteoporosis connected to arthritis?

Osteoporosis is not a form of arthritis. Rather, it is a disease in which bones become brittle and weak, and eventually may break. Fractures, such as in the hips, often have long-lasting effects, including less mobility, decreased quality of life and increased depression. Like arthritis, osteoporosis can lead to disability. If bones are weak, the joints they form just don’t work well. In addition, the underlying processes involved in arthritis may contribute to osteoporosis.

Researchers have discovered that the chemicals involved in the inflammatory process, called cytokines, inhibit bone-building. And, in some cases, medications – especially corticosteroids – used to treat joint inflammation induce osteoporosis. Age also connects people with osteoporosis and OA, because both conditions tend to occur later in life.

When does a doctor prescribe osteoporosis medications?

Doctors look at several pieces of information before prescribing a bone-preserving or bone-building medication. A key piece of information is a patient’s bone mineral density. Bone density is determined by a quick and painless dual-energy X-ray absorptiometry (DEXA) scan of the hips, spine and wrists – the bones most likely to break due to osteoporosis. People should have a DEXA scan at age 65 and at a younger age if they take corticosteroids (such as prednisone) or have rheumatoid arthritis.

In people who do not have their bone mineral density tested, bones can weaken “silently,” and a fracture may be the first indication of osteoporosis that requires treatment. For those who have a DEXA scan, results are given as a Tscore, which compares the strength of a person’s bones with the peak bone mass of young adults. If bone density is normal, the Tscore will be at or above -1. A T score ranging from -1.1 to -2.4 indicates osteopenia, a preosteoporosis condition. Osteoporosis is diagnosed if the T score is -2.5 or lower.

The National Osteoporosis Foundation recommends starting treatment for people who’s T score is -2.0 or lower, or for those who have additional risk factors (such as taking a corticosteroid) and a T score lower than -1.5. For patients on bone medications, or for those who remain at risk for osteoporosis, bone density tests may need to be repeated every one to two years. When deciding whether it’s time to prescribe an osteoporosis medication, a doctor also considers a patient’s family history of osteoporosis: lifestyle (calcium intake, exercise, smoking, alcohol use); and other factors, such as age, gender, height and weight.

How fast can osteoporosis progress without medication?

Disease progression is determined by genetics, lifestyle and environmental influences. Adequate or inadequate amounts of calcium, vitamin D and weight-bearing exercise can influence the rate of bone deterioration. Without medication, however, bones that are already weak can continue to lose density at a rate of 1 percent to 5 percent per year.

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gloria katz
15 Sep 2009, 17:25
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sirs
i have ostoporios and i am given by my doctor the drug bonivia iv every 3 months do you think i would be a person to get the new drug denosumab ?would i still take bonivia plus this new drug? i have not had any breaks of my bones but acording to my cat scans i have a grade 4 condition Do you think this new medication would help me?
sincerly yours gloria katz
ella joyner
19 Aug 2009, 22:42
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I have had a back operation L5,4,and 3. I hurt and my toes are numb and my feet and the legs. I can walk and they do not hurt as bad , I sit down or lay down I have cramps. I go to my Dr. but I need something for more relief. I would like to know why my legs are so bad , I need to know what to do, Thanks Ella Joyner
Patty
08 Jul 2009, 11:25
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I have been on Methotrexate for 6 years due to RA. When diagnosed with osteoporosis, I started taking Forteo. I had to stop Forteo after 2 months of severe pain. During that time RA really took over, metho was ineffective and is having a tough time regaining control. I am not able to take any of the infusion drugs so am hoping that metho will persevere. I am sending this as I found very little info on the internet re: the combination of these two drugs.
Thanks, Patty
Jo-Ann Boyd
05 Jun 2009, 15:51
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My Vit.D was 17 and I too had fractures from simple tasks. You must build up your Vit.D level with avengence.
I take caltrate with 600mg calcium plus 400 ml Vit D three times a day. If you count up what you get in food you will find your diet is lacking, I am sure. Milk is a fortified food.
Be sure to get sunshine. I go out without sun screen for 15 min.early in the am before the sun gets hot.
I felt much better and had less leg pain within a very short time and my Vit D level is back to normal .
Hope this is helpful. Jo-Ann Boyd
Terri Mauro
14 May 2009, 15:56
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I am trying to find some information on severe bone loss. I have had many fractures.
I am trying to heal from pelvic fractures
and sacrum fracture. My rheumatologist said
my serum Vit. D is 22. I am having a hard time finding a way to replace the vit. d.

I am allergic to yellow food and drug coloring, and seafood. Because of this I have
not found a po med I can take. Any help you
can send my way would be a miracle.

Thank you-Terri

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