Pros and Cons of Osteoporosis Medications

When you are diagnosed with osteoporosis or are at high risk, your doctor will prescribe medication for treatment or prevention. Do you have the right medication for you?

Factors you want to consider are:

1. Consult your doctor


2. Side effect


3. Does the drug have a good track record?


4. How do you prefer to take your medication (pills, fluids, injections, or sprays etc.)


5. Cost


6. How medicine works for you.

To help you with this process, the advantages and disadvantages of well-known osteoporosis medications are summarized below:

Teriparatide (Forteo)

Advantage: activates bone buildup cells, increases bone density, and reduces spine fractures for patients with severe osteoporosis

Disadvantages: require daily injections into the legs or stomach; more expensive than other options; can cause dizziness, nausea and leg cramps; should not be taken for more than 18 to 24 months

Ralozifene (Evista)

Advantage: for postmenopausal women who do not take hormone therapy; reduce bone loss rates; preventing spinal fractures; provide estrogen benefits without any side effects; can reduce the risk of breast cancer

Disadvantages: can increase heat stress and increase the risk of blood clotting

Bisphosphonates (Fosamax, Bonival, Actonel, Reclast)

Advantage: these drugs slow down bone damage and prevent spinal cord injury; prescribed to men and women for prevention and treatment; tablets or injections provided; various dosage schedules (e.g., daily, weekly, monthly). Reclast® is an exception as it is only available for postmenopausal women as an annual injection. Fosamax® and Actonel® have been effective in preventing hip fractures as well as spinal fractures.

Disadvantages: Common side effects are nausea, stomach aches, and loose bowel movements. With Fosamax® and Actonel® there is a low risk of ulcers in the throat and a rare jaw risk after dental work.

Calcitonin (Fortical, Miacalcin)

Advantage: slow down bone damage; preventing spinal fractures; help control pain; available for men and women with osteoporosis; synthetic or natural hormone choices

Disadvantages: taken as an injection or nasal spray; studies show that it may not be as effective as some drugs in improving bone density; Side effects can include dryness of the nose and swelling.

Hormone Therapy (HT)

Advantage: for menopausal women; used for prevention and treatment; also relieves symptoms of menopause; increases bone density and prevents spinal fractures

Disadvantages: Long-term use may increase the risk of breast cancer, heart disease, and stroke; alternatives were explored before this option was selected for osteoporosis; Other side effects include depression, headache, breast tenderness, and weight gain.

Careful Choice of Medicine is an Important Part of Management of Osteoporosis

Choosing your medicine is a personal decision with your doctor. Medicines are an important part of the management of osteoporosis. There are four other important ways to manage osteoporosis, which work with drugs to strengthen bones and prevent bone loss. They are:

• Regular exercise


• Diets are balanced with calcium and vitamin D supplements


• Avoid or reduce smoking, caffeine and alcohol


• Take steps to prevent falls and fractures

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