Osteoporosis Medications: How They Work
From the latest medications to daily supplements -- what's your osteoporosis medication doing for you?
Bone Remodeling Can Go Awry
As it turns out, this delicate balance of bone remodeling can become
disrupted as we get older.
"Around menopause in women, and also for some older men, this balance
becomes disordered," says Felicia Cosman, MD, clinical director of the
National Osteoporosis Foundation. "The amount of bone removed starts to
exceed the amount replaced."
The culprit? Estrogen, a hormone that helps maintain healthy bone. As
estrogen levels decline before and during menopause, "women can lose a
significant amount of bone," says Cosman.
As bone resorption exceeds growth, bones lose density and strength, becoming
more likely to break.
Osteoporosis Medication Can Restore Balance
Fortunately, osteoporosis treatments can restore the balance of bone
remodeling. Numerous osteoporosis medications are proven to rebuild bone and
"The large majority of these medicines are anti-resorptive
medications," Cosman tells WebMD. These drugs slow down bone resorption, so
bone growth has time to catch up.
Here are a few facts about several osteoporosis medications:
Bisphosphonates are the most commonly used prescription medications for
osteoporosis. There are three major drugs in this family:
Bisphosphonates enter the bones, binding to areas of bone undergoing
resorption. When osteoclasts try to dissolve bone coated with the drug, it
disrupts the osteoclasts' function. The result? Less bone gets resorbed, and
the bone has a better chance to rebuild.
"Bisphosphonates are the most effective medicines we have to treat
osteoporosis," says Mary Rhee, MD, MS, an endocrinologist and assistant
professor of medicine at Emory University in Atlanta. The key health benefits:
increased bone density and reduced risk of fracture.
Calcitonin is a hormone made in the thyroid gland. In animals, calcitonin
binds to osteoclasts, preventing bone resorption. The drug preparation of
calcitonin is usually made from salmon calcitonin, which is more potent than
Taken as a medicine, calcitonin slows bone loss, increases bone density, and
may relieve bone pain. It is most often used as additional therapy, or when
someone cannot tolerate a bisphosphonate. The key health benefit: Reducing the
risk of spinal fractures.
Raloxifene is a selective estrogen receptor modulator, or SERM,
originally used to treat breast cancer. Now, it’s also approved to prevent and
treat osteoporosis. Raloxifene binds to estrogen receptors throughout the body
to produce some estrogen-like effects. One effect is prevention of bone