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UAB Tone Your Bones

If you have osteoporosis, there are many medications you can take that can help  make your bones stronger and lower your chances of breaking a bone. Right now, there are eight drugs and one medical food that are approved for the treatment and/or prevention of osteoporosis:

Bone building medications that are for women only:

  • Estrogen or Hormone Replacement Therapy
    Types and doses vary
  • Evista (Raloxifene)
    Daily 60 mg tablet

Bone building "medical food" that is for women only:

  • Fosteum (a "medical food" that comes from soybeans)
    Twice daily 27 mg tablet

Bone Building Medications that both men & women can take:

  • Bisphosphonates:
      1. Fosamax (Alendronate)
        Weekly 70 mg. tablet
      2. Actonel (Risedronate)
        Weekly 35 mg. tablet
        Monthly 150 mg. tablet
      3. Boniva (Ibandronate)
        Monthly 150 mg. tablet
        I.V. once every three months
      4. Reclast (Zoledronic Acid)
        Infusion once a year
  • Miacalcin (Calcitonin)
    nasal spray
  • Forteo (Parathyroid Hormone)
    Injection once a day for 1 1/2 to 2 years

These medications can work very well in many people but remember:

  • Not all medications work the same in all people!
  • You still need to get the right amount of calcium from your foods or  supplements or both and also the right amount of vitamin D for the medications to work at their best.

How the Medications Work:

Most of the medications for osteoporosis work by slowing down your bone losses so that your own bone building cells can get caught up and increase your bone density. Estrogen, Evista, Fosteum, the bisphosphonates, and miacalcin all work in this way:

  • Your bones have two types of cells that are always at work: osteoblasts which build bone and osteoclasts which break down bone.  Think about your bones as a savings account with bone constantly being deposited and withdrawn.
  • As we age, the bone builders slow down - they're still working, they're just not building as much bone as they used to.
  • Also as we age, the bone breakdown cells speed up - working harder and breaking down more bone than ever before.
  • Since the bone building cells can't quite keep up, we end up losing more bone than we can build. So, the balance in your bone bank goes down.
  • Some medications for osteoporosis slow down the bone breakdown cells so that your own bone builders can catch up and increase the bone density or bone strength.  In other words, these medication change your bone balance so that you can actually get some of your lost bone back. 

One medication, Forteo, builds bone by making the bone building cells work harder.

So, the overall result of taking a medication for osteoporosis should be to increase your bone density. You may hear these types of medications called "anti-resorptive medications".

It is important to discuss your medication options with your osteoporosis specialist and for you to play a role in deciding which medication you will try. Everyone responds to the medication differently - some building more bone than others. Your physician should follow your progress and let you know if you are increasing your bone density over the years. 

You should always call your physician if you have any side effects that you think are caused by your medications.  On the next two pages, you will find more information about each of the medications that are now approved to treat osteoporosis.

Forteo (Parathyroid Hormone)