Osteoporosis medicines

Medicines to treat osteoporosis

Key points about medicines for osteoporosis

  • Medicines used for osteoporosis work by slowing or stopping bone loss or rebuilding bone.
  • The preferred medicines to treat osteoporosis are called bisphosphonates, for example alendronate, risedronate and zoledronate.
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These medicines work on the bone-making cells to slow loss of bone and help restore some bone that has been lost. They have been shown to reduce the fracture rate in people with osteoporosis.

Common examples of bisphosphonates for osteoporosis include alendronate (Fosamax or Fosamax Plus, which includes Vitamin D) and risedronate tablets. These tablets are taken only once a week, you need to follow instructions carefully to avoid side effects and make sure the medicine is absorbed so it's effective.

Bisphosphonates are usually given in conjunction with monthly vitamin D supplements. A funded alternative to tablets is zoledronic acid, which is given as an injection into a vein. It takes around 10–15 minutes to administer and then is usually only needed about once every 18 months. Read more about bisphosphonates.

Menopausal hormone therapy (MHT) may be used as a treatment for osteoporosis in some people with low oestrogen levels due to menopause. MHT increases bone density and reduces fracture rates. The use of MHT for osteoporosis is generally considered for younger postmenopausal women, within 10 years of menopause, with menopausal symptoms, and who are at high risk of fractures. MHT can be continued for up to 5 years, but bone loss starts again, when MHT is stopped. Read more about menopausal hormone therapy (MHT).   

Raloxifene tablets work by copying the effects of oestrogen on bone, thus increasing bone density and may be considered for use by post-menopausal women who can't tolerate oestrogen. Read more about raloxifene.

Other medicines that may be considered in the treatment of osteoporosis include denosumab and teriparatide. They are generally only used when other medicines have been unsuccessful. They require special authority forms and you must meet specific criteria for them to be appropriate treatments.

Calcium is an important component of bone. It's therefore important to get enough calcium from your diet to maintain healthy bones, but there is no evidence that taking more than this is helpful. If you have difficulty getting enough calcium from food sources (about 4 serves of dairy per day), calcium supplements may be recommended. 

Calcium supplementation slows bone loss but does not usually stop it completely. If you have osteoporosis and have had a fracture, calcium alone is not enough to prevent further fractures – you will also need a specific osteoporosis treatment. However, you need to get adequate calcium and vitamin D to support your bone health while you are on osteoporosis treatment.

The most common calcium supplement is calcium carbonate. Read more about calcium supplements.

Vitamin D is essential for maintaining healthy bones and muscles. Your body makes most of the vitamin D it needs in your skin when exposed to sunlight. Some people, such as those who spend a lot of time indoors and those with dark skin, may have difficulty producing enough vitamin D.

If you have osteoporosis, vitamin D tablets called colecalciferol may be recommended. These tablets are only taken once a month. Read more about colecalciferol.

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