Carl R. Darnall Army Medical Center - Health Library

Medications for Osteoporosis

The information below is meant to help you learn about these medicines. Only the most common side effects are listed. Ask your doctor if you need to take any special care. Use each of these medicines as advised by your doctor. If you have further questions, call your doctor or pharmacist.

Prescription Medications

Bisphosphonates

  • Alendronate
  • Risedronate
  • Ibandronate
  • Pamidronate
  • Etidronate
  • Zoledronic acid

Hormone replacement therapy (HRT)

  • Estrogen alone—estrogen replacement therapy (ERT)
  • Estrogen and progestin HRT—also called combined HRT

Other medications

  • Raloxifene
  • Calcitonin
  • Denosumab
  • Teriparatide

Bisphosphonates

Common names:

  • Alendronate
  • Risedronate
  • Ibandronate
  • Pamidronate
  • Etidronate
  • Zoledronic acid—given through an IV

If you’ve been through menopause and have osteoporosis, these may give you:

  • Reduced bone loss
  • Higher bone density in the spine and hip
  • Reduced risk of breaks in the spine and hip

Bisphosphonates that come as a pill should be taken in the morning. Take it with a full glass of water. Also take it at least 30 minutes before eating or drinking. Stay upright for at least 30 minutes after taking it.

Possible side effects:

Hormone Replacement Therapy (HRT)

Estrogen Replacement Therapy (ERT)

Common brand names:

  • Premarin
  • Ogen
  • Estrace
  • Estraderm
  • Estratab

ERT has been used to prevent and treat osteoporosis. ERT has been shown to:

  • Lower bone loss
  • Raise bone density in the spine and hip
  • Lower the chances or breaks in the spine and hip women who have been through menopause

ERTcomes as a pill or skin patch.

ERT may lower your chances of osteoporosis. There may be a strong link between longer term ERT or HRT use and other health problems. These include invasive breast cancer, strokes, heart attacks, and blood clots. Be sure to talk to your doctor about the risks.

Estrogen and Progestin HRT (Combined HRT)

Common brand names:

  • Activella
  • Femhrt
  • Ortho-Prefest
  • Premphase
  • Prempro

Combined HRT has been used to prevent and treat osteoporosis. Combined HRT has been shown to:

  • Lower bone loss
  • Raise bone density in the spine and hip
  • Lower the chances or breaks in the spine and hip women who have been through menopause

Combined HRT is taken as a pill.

HRT may lower your chances of osteoporosis. There may be a strong link between longer term ERT or HRT use and other health problems. These include invasive breast cancer, strokes, heart attacks, and blood clots. Be sure to talk to your doctor about the risks.

Other Medications

Raloxifene

Raloxifene is one of a class of drugs that work on estrogen receptors in the body. It helps prevent bone loss at the spine, hip, and total body. They may raise bone mass. This medicine may also lower the risk of breaks in the spine and breast cancer. Raloxifene is taken as a pill and once a day, with or without meals.

Possible side effects:

  • Hot flashes
  • Headache
  • Nausea and vomiting
  • Diarrhea
  • Joint pain
  • Leg pain
  • Sleep problems
  • Higher risk of blood clots and stroke—rare

Calcitonin

Calcitonin is a natural hormone that:

  • Slows bone growth
  • Raises bone density
  • Lowers the risk of breaks in the spine

It may also help lower or ease the pain of bone breaks. Calcitonin is approved for women who are at least 5 years past menopause. It can be taken as a shot or used as a nasal spray.

Possible side effects from a shot:

  • Allergic reaction
  • Flushing of the face and hands
  • Passing urine more frequently
  • Nausea
  • Skin rash

The nasal spray may cause a runny nose.

Denosumab

Denosumab is given as a shot. It’s type of monoclonal antibody. The medicine works by seeking out cells called osteoclasts. These cells breakdown bone.

Denosumab is for women who have:

  • Gone through menopause
  • Osteoporosis
  • A high risk of broken bones

Common side effects:

  • Back pain
  • Pain in the arms or legs
  • Pain in muscles, soft tissues, or bones
  • High cholesterol levels
  • Bladder infections

Teriparatide

Teriparatide is given as a shot from a pen. It’s a man-made form of parathyroid hormone, which stimulates bone growth. Teriparatide is used for people who are at high risk for breaks or are taking corticosteroids.

Common side effects:

  • Neck pain
  • Headache
  • Weakness
  • Nausea or vomiting
  • High blood pressure
  • Lightheadedness
  • Fainting
  • Rash
  • Sweating

Special Considerations

If you are taking medications, follow these general guidelines:

  • Take the medication as directed. Do not change the amount or the schedule.
  • Ask what side effects could occur. Report them to your doctor.
  • Talk to your doctor before you stop taking any prescription medication.
  • Do not share your prescription medication.
  • Medications can be dangerous when mixed. Talk to your doctor or pharmacist if you are taking more than one medication, including over-the-counter products and supplements.
  • Plan ahead for refills as needed.
REFERENCES:

Bisphosphonates for treatment and prevention of osteoporosis. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T900139/Bisphosphonates-for-treatment-and-prevention-of-osteoporosis. Updated July 19, 2017. Accessed June 25, 2018.

Calcium and vitamin D for treatment and prevention of osteoporosis. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T115372/Calcium-and-vitamin-D-for-treatment-and-prevention-of-osteoporosis. Updated May 24, 2018. Accessed June 25, 2018.

Hormonal replacement therapy (HRT) and osteoporosis. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T114458/Hormonal-replacement-therapy-HRT-and-osteoporosis. Updated May 8, 2014. Accessed June 25, 2018.

Osteoporosis. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T113815/Osteoporosis. Updated February 1, 2018. Accessed June 25, 2018.

Osteoporosis overview. NIH Osteoporosis and Related Bone Diseases National Resource Center website. Available at: https://www.bones.nih.gov/health-info/bone/osteoporosis/overview. Updated February 2017. Accessed June 25, 2018.

Treatment. National Osteoporosis Foundation website. Available at: https://www.nof.org/patients/treatment. Accessed June 25, 2018.

3/11/2013 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T900139/Bisphosphonates-for-treatment-and-prevention-of-osteoporosis: Reid IR, Black DM, Eastell R, et al. Reduction in the risk of clinical fractures after a single dose of zoledronic acid 5 milligrams. J Clin Endocrinol Metab. 2013;98(2):557-563.

Last reviewed June 2018 by EBSCO Medical Review Board Marcie L. Sidman, MD  Last Updated: 6/25/2018