Picking the Right Osteoporosis Medicine for You
Here are 6 types of osteoporosis medicine to consider.
No. 1: Bisphosphonates: Fosamax, Actonel, Boniva, Zoledronic Acid (Reclast or Zometa) continued...
The Dosing Options: There's lots of flexibility in taking bisphosphonates -- depending on whether you want to take osteoporosis medicine daily, weekly, monthly -- or get a once-a-year intravenous (IV)treatment in your doctor's office.
- Fosamax can be taken daily or weekly in pill form.
- Liquid Fosamax can be taken weekly.
- Actonel can be taken daily, weekly, or monthly.
- Boniva can be taken once a day or monthly in pill form.
- An intravenous (IV) form of Boniva can be given once yearly.
- Reclast or Zometa is a once-yearly IV infusion treatment.
An IV infusion involves a needle in your arm and a drip bag -- just like you get in a hospital. While it may sound like a slightly extreme way to get a medication, it has its advantages. "The IV drug goes directly to the bone, bypassing the GI tract entirely," Scopelitis says.
The procedure itself takes about five minutes for Boniva and 15 minutes for Reclast -- and you're done for the year. "It can be a practical option for some patients," Tanner says.
The Pill Regimen: Taking osteoporosis medicine in pill form is serious business. You don't just pop the pill. You must follow specific guidelines.
- The drugs must be taken first thing in the morning -- on an empty stomach.
- You cannot sit or lie down after taking it.
- You cannot eat or drink anything.
- You must wait for 30 to 60 minutes for the body to absorb the medicine.
- When that time period is over, you can take other medications.
The longer you wait before putting something in your stomach, the better chance the osteoporosis medicine will be absorbed. "Your stomach has to be empty," says Scopelitis. "You have to make sure there is no competition in the GI tract for the drug." You can take other medications later that morning -- but not before taking the osteoporosis medicine.
This intense regimen is important, explains Thacker, because very little of the drug is actually absorbed by the body. The body absorbs only about 1% of the drug -- "so you have to make sure you get the most from every dose," she says.
Weighing the Options: When deciding about bisphosphonates, ask yourself these eight questions:
- How frequently do you want to take an osteoporosis medicine?
- Will you really remember to take it?
- Will you follow the morning regimen for taking the pills?
- Are you taking other medications regularly?
- Do you have any GI problems?
- Do you have difficulty swallowing?
- Would you rather have a once-yearly treatment?
- What osteoporosis medicine does your insurance cover?
Pill-form bisphosphonates are not advised for people with GI problems like gastritis or ulcers -- or for people with serious esophageal problems like stricture. "We want to make sure patients absorb the drug," says Thacker. "If they have those conditions, they really need to consider an IV."