Picking the Right Osteoporosis Medicine for You
Here are 6 types of osteoporosis medicine to consider.
No. 2: Evista: Breast Cancer and Osteoporosis Prevention
For women with osteopenia [low bone density but not yet osteoporosis] -- or who have difficult GI problems taking bisphosphonates -- Evista is an option. Evista is a selective estrogen receptor modulator, or SERM, used to treat breast cancer. It is also approved by the FDA to prevent and treat osteoporosis.
The drug binds with estrogen receptors throughout the body to produce some estrogen-like effects -- including prevention of bone loss.
Evista helps prevent spine fracture, not hip fracture, reports Thacker. "Evista is not as potent as estrogen therapy or bisphosphonates on bone. But the FDA has approved it for osteoporosis, and to reduce risk of breast cancer. Women can get those extra benefits from Evista."
Possible side effects: Though rare, there is risk of deep vein thrombosis.
No. 3: Forteo: The Bone Builder
If you are treating severe osteoporosis, you likely need a medicine called Forteo. Forteo is a parathyroid hormone that increases bone density and bone strength to prevent fractures. Forteo stimulates bone-forming cells called osteoblasts to build bone. This osteoporosis medicine has a dramatic effect on bone density in the spine and reduces fracture by up to 90%.
Forteo is given daily day for a period of time, and must be injected. This osteoporosis medicine is generally prescribed for people with severe osteoporosis, or who have already had one or more fractures. You can inject it yourself at home, or have someone else do it.
"Forteo builds up bone, whereas the other drugs keep bone from breaking," explains Scopelitis. "Women who have very severe osteoporosis will skip the other drugs and go for Forteo, which is stronger."
Possible side effects: Some people report feeling light-headed or fainting; fast or pounding heartbeats when injecting the medicine; or nausea, vomiting, constipation, and muscle weakness.
No. 4: Denosumab: In the Pipeline
Like Forteo, this osteoporosis treatment also builds bone. Phase 3 trials showed a decreased rate of vertebral and hip fractures. The drug activates bone-building osteoblasts by a different mechanism than Forteo does. This new osteoporosis drug is injected, but women may need injections just a few times a year. The drug is due for a 2009 launch, reports Ruppe.
"The preliminary information on denosumab looks good," Tanner tells WebMD. "People who haven't tolerated or benefited from other drugs may find it useful."
No. 5: Calcitonin: For Combination Therapy
Calcitonin is the oldest drug for treating osteoporosis, approved in 1984 -- and is still used occasionally. It is a hormone made from salmon calcitonin, and helps to slow bone loss, increases bone density, and may relieve bone pain. It works by binding with damaging cells called osteoclasts, preventing bone loss. Calcitonin's key benefit is reducing risk of spinal fractures.
Calcitonin is often used as an additional osteoporosis medicine or when someone cannot tolerate a bisphosphonate. It may be given as an injection.
Possible side effects: Diarrhea, flushing of face or hands, increased urination, loss of appetite.