Osteoporosis treatment: Medications can help

Osteoporosis treatment may involve medication along with lifestyle change. A Mayo Clinic specialist answers some of the most common questions about osteoporosis treatment.

By Mayo Clinic Staff

If you're undergoing osteoporosis treatment, you're taking a step in the right direction for your bone health. But you might have many questions about your therapy. Is the medication you're taking the best one for you? How long will you have to take it? Why does your doctor recommend that you take a weekly pill when your friend takes a pill only once a month?

Kurt Kennel, M.D., a specialist in endocrinology at Mayo Clinic in Rochester, Minn., answers common questions about osteoporosis treatment in women and describes how osteoporosis medications work.

Which medications are commonly used for osteoporosis treatment?

Bisphosphonates are the most common medications prescribed for osteoporosis treatment. These include:

  • Alendronate (Fosamax)
  • Risedronate (Actonel, Atelvia)
  • Ibandronate (Boniva)
  • Zoledronic acid (Reclast, Zometa)

Hormones, such as estrogen, and some hormone-like medications approved for preventing and treating osteoporosis, such as raloxifene (Evista), also play a role in osteoporosis treatment. However, fewer women use estrogen replacement therapy now because it may increase the risk of heart attacks and some types of cancer.

How do bisphosphonates work?

Bisphosphonates slow the bone breakdown process. Healthy bones are in a state of continuous breakdown and rebuilding. As you get older, and especially after menopause when your estrogen levels decrease, the bone breakdown process accelerates. When bone rebuilding fails to keep pace, bones deteriorate and become weaker. Bisphosphonates basically put a brake on that. These drugs effectively preserve or maintain bone density during menopause — and decrease the risk of breaking a bone as a result of osteoporosis.

How do you know if you're taking the right medication?

Drugs in the bisphosphonate class are more alike than they are different. Some studies show differences in potency or effectiveness at maintaining bone density, but they're all still effective drugs. All bisphosphonates have been shown to reduce the chance of a fracture. The decision to take one drug over another often is based on:

  • Preference
  • Convenience
  • Adherence to the dosing schedule

Your doctor might recommend a monthly dose of medication if it's going to be better tolerated or better accepted. But if you're the type of person who might forget to take your medicine every month, you might do better taking it once a week.

What are common side effects of bisphosphonate pills?

The main side effects of bisphosphonate pills are:

  • Stomach upset
  • Heartburn

To ease these potential side effects, take the medication on an empty stomach with a tall glass of water. And don't lie down or bend over for 30 to 60 minutes to avoid the medicine washing back up into the esophagus. The majority of women who follow these tips don't experience these side effects. But it's possible for an unlucky few who take the medicine correctly to still have stomach upset or heartburn.

Aug. 23, 2011 See more In-depth