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Do Your Medications Affect Your Bones?

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WebMD Feature

If you have osteoporosis, or are at risk for it, you want to do all you can to keep your bones as strong as possible. Besides following your doctor's advice on diet and exercise, you should know that some medications are bone-friendly -- and others may have side effects that affect the bones.

Some medications prescribed for common health problems, such as heartburn or depression, could affect your bone health.

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"That doesn't necessarily mean you should stop them," says Harold Rosen, MD, director of the Osteoporosis Prevention and Treatment Center at Beth Israel Deaconess Medical Center in Boston.

Rather, "it's crucial to weigh the pros and cons: the benefits of the medicine against the effect on the bones," he says.

The benefits of a drug may outweigh the risks. Or your doctor may prescribe a ''bone-maintenance" drug to offset the risk, Rosen says.

Corticosteroid Drugs and Bone Health

This type of steroid drug helps curb inflammation. Doctors prescribe them for conditions including rheumatoid arthritis, asthma, and ulcerative colitis.

Some examples include:

  • cortisone (Cortone)
  • prednisone (Deltasone, Meticorten, Orasone, Prednicot)

These steroids hamper bone formation and increase bone resorption, which can make a fracture more likely, notes  endocrinologist Ann Kearns, MD, a consultant at the Mayo Clinic in Rochester, Minn.

However, she says, some people need these drugs. And the ''short-term risk is not a big deal for most people," Rosen says.

How you take the drugs may also matter. Pills or shots are the most powerful, but those you inhale or put on your skin are "less concerning," Kearns says.

Anti-Cancer Drugs and Bone Health

If you've had breast cancer and are taking certain drugs that affect your bones, your doctor should monitor your bone density and may prescribe a bone-maintenance drug.

Some breast cancer patients take a type of drug called an aromatase inhibitor. These drugs include:

  • anastrozole (Arimidex)
  • exemestane (Aromasin)
  • letrozole (Femara)

These drugs target a substance your body makes called aromatase. That leads to lower estrogen levels, which can dim estrogen-fueled cancers.

That's good news for your cancer, but lowering your estrogen levels can be bad for your bones, since estrogen stops bone resorption. That's why doctors often prescribe improved lifestyle changes such as exercise, a diet rich in calcium and vitamin D, and bone-maintenance drugs to women who are taking the aromatase inhibitors. 

Men who have been treated for prostate cancer are sometimes prescribed anti-androgen therapy. Examples of these drugs include bicalutamide (Casodex), flutamide (Eulexin), and nilutamide (Nilandron).

These drugs block the action of the hormone testosterone, usually slowing prostate cancer growth. However, these medications can decrease bones' density and increase fracture risk, so doctors may prescribe changes in lifestyle such as exercise, smoking cessation, reduced caffeine intake, and a bone-maintenance drug.

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