Know the Pros and Cons of Common Osteoporosis Medications

May 16, 2019 Providence Health Team

You’ve seen the television commercial showing a woman on the floor who’s “fallen and can’t get up” presumably due to a broken leg or hip. Although the commercial, its low production value, and parodies over the years may seem silly, osteoporosis and the broken bones that accompany it are no laughing matter.

Millions of people—most of them women—are either at risk for osteoporosis or have already been diagnosed with this widespread disease. The National Osteoporosis Foundation estimates that one in two women will break a bone due to osteoporosis.

Why does this disease affect so many people? Osteoporosis weakens your bones as you age, making them thinner, fragile, and prone to breaking. Your hip, spine, and wrist bones are the most vulnerable, but any of your bones can be affected.

If you are at risk, your doctor may prescribe medication to slow, or even stop, the disease’s progression. Knowing the pros and cons of your medication options can help you make an informed decision about what’s for best you and your continued good health.

What are your choices?

Bisphosphonates

Bisphosphonates are the most commonly prescribed medications used to treat osteoporosis. They work by slowing down the rate at which your bones break down.

You may have heard of the most popular brands, like:

  • Actonel—a tablet you take daily or weekly
  • Boniva—an injection you get every three months
  • Fosamax—a tablet you take daily or weekly
  • Reclast—a treatment you take intravenously initially and every two years after that

Pros:

  • Greatly reduced chance of fractures caused by fragile, weakened bones
  • Effective results, with hip fractures reduced by half and spine fractures by 70 percent
  • Benefits continue even after you’re no longer taking the medication

Cons:

  • Side effects include upset stomach and heartburn
  • One in 50,000 people develop jawbone problems
  • In 1 percent of users, bisphosphonates can cause a broken thigh bone, called a femoral fracture

Denosumab

Denosumab, which includes the brands Prolia and Xgeva, is a shot you get every one to six months. It stops the cells that break down your bones and decreases your risk of bone loss and fractures.

Denosumab is usually prescribed when bisphosphonates are not a good choice for you—either because they did not work effectively or because there’s a reason you should not take them.

Pros:

  • Highly effective osteoporosis treatment
  • Decreases spine fractures by nearly 70 percent
  • Reduces hip fractures by 40 percent

Cons:

  • May lower your calcium levels
  • May increase risk of certain skin infections
  • May cause muscle pain or skin problems

Hormone therapy

There are a variety of different hormones can be used to treat osteoporosis. Some examples include:

  • Estrogen therapy that can help you maintain bone density
  • Medications like Evista that mimic estrogen and reduce bone loss, without some of the risks of natural estrogen
  • Manmade hormones like Forteo that stimulate new bone growth

Pros:

  • If you can’t take other medications, hormone treatment can be an effective alternative.
  • Some hormone treatments can help your body grow new bone if your bone density is low or you’ve already had broken bones.
  • It significantly improves bone density in your spine.

Cons:

  • It may increase your risk of certain cancers in rare cases.
  • Side effects can include dizziness, fainting, and lightheadedness.
  • It may cause blood clots or stroke.

If you need a primary care doctor who understands osteoporosis and its range of treatment options, the experts at Providence are here to help. You can find a doctor using one of the regional directories below, or you can search for a doctor that’s right for you in our provider directory.

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