Osteoporosis is defined as bone loss and weakness, which can lead to increased risk of bone breakage or fracture. Osteoporosis largely affects the elderly and doesn’t present any symptoms until a bone is broken when the diagnosis of osteoporosis is made. Decreased levels of estrogen after menopause make women more susceptible to early onset osteoporosis and while there is no immediate cure for this disease, there are various medications prescribed to halt the bone loss and weakness and increase the bone health. As in any disease; some medications work better for the continued treatment of osteoporosis than others and with this article; the aim is to further discuss effective treatment options for osteoporosis. Read further to know more.

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How Do Medications for Osteoporosis Work?

How Do Medications for Osteoporosis Work?

Before going in to details about the best treatment options for osteoporosis, it is important to look into the inner workings of osteoporosis medications and the effect they have on the bones. Even healthy bones are susceptible to dissolution followed by rebuilding; age and menopause can accelerate the dissolution process and slow the rebuilding process. Osteoporosis medications primarily slow down the dissolution process and allow the rebuilding process to catch up. With the exception of teriparatide; all osteoporosis medications work in the same manner.

What are the Best Medications for Treating Osteoporosis?

Bisphosphonates for Osteoporosis Treatment

Biophosphonates are the specific class of drugs used to treat osteoporosis over a rather long period of time. Bisphosphonates are by far the most commonly prescribed drugs and one of the best medications for osteoporosis and are known to result in a substantial decrease in bone loss and bone weakness while simultaneously lowering the risk of bone breakage.

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Osteoclasts are a group of large and multinucleated cells that are largely responsible for the degradation of bone mass. These cells are effectively countered by Bisphosphonates by slowing them down and allowing the osteoblasts or bone building cells to have a greater and positive influence on bone mass and strength. Thus, Bisphosphonates effectively strengthen bones, reduce bone loss and substantially decrease the risk of bone breakage in those diagnosed with osteoporosis. The primary action of Bisphosphonates is inhibiting osteoclasts that are responsible for resorption of bone and clearing the way for osteoblasts to engage in bone building. It is possible that Bisphosphonates are absorbed and retained by bones for many years and have continued beneficial effects on bones with long term treatment.

Doctors will generally advise an osteoporosis patient to take Biophosphonates immediately after waking up in the morning and on an empty stomach. These medications need to be taken with a substantial amount of water and should be followed up with avoidance of food and drinks or other medications for half an hour at the very least.
Bisphosphonates treatment for osteoporosis is generally a long term course and patients are generally prescribed these drugs for periods of time; ranging from 10 years for oral Bisphosphonates and 6 years for intravenous Bisphosphonates. This is the closest general treatment duration that mainly applies to women and doctors may prescribe otherwise based on various factors. Doctors often require patients to reassess fracture risks every two or three years and prescribe osteoporosis treatment accordingly.
Like any other medication; Bisphosphonates have their fair share of side effects and a patient is required to discuss any additional symptoms experienced after starting off on Bisphosphonates. Side effects of Bisphosphonates include:

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  • Increased bone aches for a period of time; right after initially starting off on a course of Bisphosphonates for osteoporosis treatment.
  • Mild discomfort and inconvenience due to digestive issues.
  • Flu like systems when Bisphosphonates are delivered intravenously.
  • Skin rashes.

While all of the above symptoms tend to go away with time; changes in kidney function and osteonecrosis caused by Bisphosphonates can be cause for concern, which needs additional attention from a doctor.

Primary Bisphosphonates prescribed are: Alendronate (Fosamax), Risedronate (Actonel), Ibandronate (Boniva) and Zoledronic acid (Reclast).

Hormone Replacement Therapy for Treating Osteoporosis

Bisphosphonates are the most commonly prescribed drugs for osteoporosis treatment however they are by no means a standalone class of drugs prescribed by doctors to osteoporosis patients. Other drugs are also prescribed by doctors in special circumstances such as hormone replacement therapy.

As osteoporosis is often caused by decrease in estrogen in post menopausal women; hormone replacement therapy is often used to prevent and treat osteoporosis. This is definitely not the most preferred course of treatment, as the side effects of hormone replacement need to be taken into consideration and doctors often prescribe the lowest doses of estrogen hormones for the shortest duration of time.

Medications with Hormone like Properties for Treating Osteoporosis

Medications with hormone like properties such as raloxifene are also prescribed for both prevention and treatment of osteoporosis.

Denosumab for Treating Osteoporosis

Denosumab is a newer drug that is currently being prescribed to those who cannot be prescribed Biophosphonates due to impaired kidney functions. Denosumab has proven to reduce the chances of bone fracture in both men and women afflicted by osteoporosis.

Teriparatide for Treating Osteoporosis

Teriparatide is specifically meant for the treatment of osteoporosis in men and post-menopausal women who have been diagnosed with abnormally low bone density with a history of fractures and osteoporosis brought on by steroid medications. Teriparatide has a well-documented bone building effect in such patients and is considered one of the best medications for osteoporosis.

Abaloparatide for Treating Osteoporosis

Abaloparatide is the newest option for osteoporosis treatment in the market and is similar to teriparatide; it helps to rebuild bone. Research has shown abaloparatide to be as effective as teriparatide and also less likely to have the side effect of excess calcium production.

Conclusion

It is important to note that this article is merely for informative purposes and makes way for osteoporosis patients to better understand the drugs that they have been prescribed for the treatment of their bone related ailment. This article; by no means, encourages self-prescription of any of the osteoporosis drugs mentioned above as osteoporosis is best treated under the guidance of a qualified bone specialist. Additionally drugs and medications are hardly the only form of therapy for osteoporosis treatment; in fact all drugs and medications must be taken in conjunction with exercise and diet that supports bone health.

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Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: January 25, 2018

This article does not provide medical advice. See disclaimer

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