Health Issue: Osteoporosis
Treatment for Osteoporosis
A comprehensive osteoporosis treatment program includes a focus on proper nutrition, exercise, and safety issues to prevent falls that may result in fractures. In addition, your physician may prescribe a medication to slow or stop bone loss, increase bone density, and reduce fracture risk.
Therapeutic Medications. Currently, alendronate, raloxifene and rise dronate are approved by the U. S. Food and Drug Administration(FDA) for the prevention and treatment of postmenopausal osteoporosis. Teriparatide is approved for the treatment of the disease in postmenopausal women and men who are at high risk for fracture. Estrogen/hormone therapy(ET/HT) is approved for the prevention of postmenopausal osteoporosis, and calcitonin is approved for treatment. In addition, alendronate is approved for the treatment of osteoporosis in men, and both alendronate and rise dronate are approved for use by men and women with glucocorticoid-induced osteoporosis.
Bisphosphonates: Alendronate (Fosamax) and Risedronate (Actonel) are pills that need to be taken on an empty stomach with water. These medications help slow down bone loss and have been shown to decrease the risk of fractures.
Raloxifene. Raloxifene (brand name Evista®) is a drug that is approved for the prevention and treatment of postmenopausal osteoporosis. It is from a new class of drugs called Selective Estrogen Receptor Modulators (SERMs) that appear to prevent bone loss at the spine, hip, and total body. Raloxifene has been shown to have beneficial effects on bone mass and bone turnover and can reduce the incidence of vertebral fractures. While side-effects are not common with raloxifene, those reported include hot flashes and deep vein thrombosis, the latter of which is also associated with estrogen therapy. Additional research studies on raloxifene will be ongoing for several more years.
Calcitonin. This medication is a hormone made from the thyroid gland and is usually given as a nasal spray or as an injection under the skin. It may help prevent spine fractures, and is also helpful to control pain after an osteoporotic vertebral (spine) fracture.
Teriparatide. Teriparatide is a form of parathyroid hormone that helps stimulate bone formation. It is approved for use in postmenopausal women and men at high risk for osteoporotic fracture. It is given as a daily injection under the skin and can be used for up to 2 years. If you have ever had radiation treatment to your bones or if you have parathyroid hormone levels that are already too high, you should not take this medication.
Estrogen/Hormone Therapy. Estrogen therapy alone or in combination with another hormone, progestin, has been shown to decrease the risk of osteoporosis and osteoporotic fractures in women. However, the combination of estrogen with a progestin has been shown to increase the risk for breast cancer, strokes, heart attacks and blood clots. Estrogens alone may increase the risk of strokes. Given the complexity of this decision, consult with your doctor about whether hormone replacement therapy is appropriate for you.