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Picking the Right Osteoporosis Medicine for You

Here are 6 types of osteoporosis medicine to consider.
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No. 1: Bisphosphonates: Fosamax, Actonel, Boniva, Zoledronic Acid (Reclast or Zometa) continued...

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:

  1. How frequently do you want to take an osteoporosis medicine?
  2. Will you really remember to take it?
  3. Will you follow the morning regimen for taking the pills?
  4. Are you taking other medications regularly?
  5. Do you have any GI problems?
  6. Do you have difficulty swallowing?
  7. Would you rather have a once-yearly treatment?
  8. 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."

Also, for patients who don't have a pharmacy benefits plan -- with their insurance or with Medicare -- intravenous Reclast or Boniva may be the better option, says Tanner. "Because it's done at the physician's office, it will be covered." However, you must meet your insurance deductible and co-pay.

Generic Fosamax: If you are a good candidate for pill form, Fosamax is now available in a cheaper, generic form. It's a good option if finances are a problem, Tanner says. "Some people can't afford more than $4 a month." It's important to know, however, that generics are required to be 80% equivalent to the brand medicine, and may not be 100% identical, she tells WebMD. "For a medication that is so difficult for the body to absorb, I think that's a risk."

Possible side effects: These osteoporosis medicines can upset the stomach, causing heartburn for a day or two. "Actonel seems to cause a bit less GI side effects," says Ruppe.

Some patients report muscle and joint pain with these osteoporosis treatments, but only rarely is it a serious problem. "It's not a reason to stay away from the medication," Tanner says.  

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Osteoporosis Glossary

  • Bone Mineral Density - A measurement of the amount of calcium and minerals in bone tissue.
  • Calcium - A mineral in (and vital to) your bones. If your body lacks calcium, it takes it from bones.
  • DEXA (dual energy X-ray absorptiometry) - a test used to measure bone mineral density.
  • Osteoporosis - A decrease in bone density, which increase the risk of fractures.
  • Vitamin D - A vitamin that helps your body absorb calcium.
  • View All Terms

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