Osteoporosis, a condition in which the density of the bones decreases, predisposes the patient to fractures. Aging, menopause, low intake of Vitamin D and calcium, as well as other disorders, can cause osteoporosis, according to the Merck Manual. Although some patients have no symptoms, others develop bone deformities and experience pain. Treatment includes exercise; adding Vitamin D and calcium supplements to the diet; and taking medications to increase bone density.
Bisphosphonates
Bisphosphonates are a form of anti-resorptive medication that help to prevent and treat osteoporosis by preventing bone loss. They increase bone density in the spine and hips and reduce the likelihood of fracture but the rate of new bone growth does not increase, says the National Osteoporosis Foundation. Two of the bisphosphonates alendronate and risedronate may be taken by mouth with a full glass of water, according to the Merck Manual. These medications can irritate the esophagus and cannot be given with food. Zoledronic acid may be given by intravenous line and ibandronate is available in oral and IV forms. Bisphosphonates may be taken safely for at least five years. Some patients, including those who are pregnant, have severe kidney disease or who have low blood calcium levels, should not take bisphosphonates.
Other Antiresorptive Medications
Calcitonin reduces the breakdown of bone but seems to be less effective in reducing the risk of fractures, according to the Merck Manual. It can also reduce the level of calcium in the blood. Calcitonin is available in IV and nasal spray forms. The U.S. Food and Drug Administration approved denosumab, an antiresorptive medication, in June 2010, for the treatment of postmenopausal women at high risk of breaking a bone, according to the National Osteoporosis Foundation. Injected every six months, this medication reduced the incidence of new spine fractures by 68 percent in clinical trials; reduced hip fractures by 40 percent; and reduced the rate of fracture of others bones in the body by 20 percent.
Hormone Therapy
Hormone supplements such as estrogen can maintain bone density in women, especially if it is started within four to six years after menopause, says the Merck Manual. However, the risks of developing breast cancer may outweigh the benefits of the medication, so hormonal therapy is not the treatment of choice for osteoporosis. Raloxifene, an estrogen-like drug, has fewer side effects than estrogen but may be less effective in preventing or treating osteoporosis, according to the Merck Manual. It may also reduce the risk of breast cancer and spinal fractures. Men may benefit from testosterone therapy if their levels are low.
Synthetic Hormones
An injectable, synthetic form of parathyroid hormone called teriparatide increases bone density, forms new bone and reduces the risk of fractures, according to the American Academy of Orthopaedic Surgeons. Patients who do not respond well to bisphosphonates or cannot take them, as well as those with severe osteoporosis, may require this medication.
