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...
However, the side effects are the main reason people quit their osteoporosis medicine, Ruppe tells WebMD. That's when the bone resorption marker test can help. "It can show the effect of medication, whether it's working. Somebody who needs reassurance needs this. It's positive reinforcement to keep taking the medication."
Because Reclast is given once-yearly in treating osteoporosis, some patients are nervous about side effects -- whether they will last a whole year, says Tanner. "About 20% get a flu-like illness the first few days afterwards. A very rare event is bone pain that may go on for awhile. But less than 1% get that. It's pretty rare." Treatment with ibuprofen (such as Advil, Motrin) or acetaminophen (such as Tylenol) helps improve the symptoms.
Considering the risks:
Atrial fibrillation (abnormal heart rhythms) has been a concern. A large study showed that some patients treated with Zoledronic acid (Reclast or Zometa)had more abnormal heart rhythms than those treated with placebo. Other follow-up studies did not show this effect. The FDA has advised that patients should not stop taking bisphosphonates -- but to report side effects and symptoms to their doctors.
There is also slight risk of osteonecrosis of the jaw, which can cause pain, swelling, exposed bone, local infection, and fracture of the jaw. But osteonecrosis is rare and has been seen in patients who have had chemotherapy or radiation therapy and are receiving long-term bisphosphonate therapy, says Tanner. "It's extremely rare," he tells WebMD. "The benefit of preventing bone fractures far outweighs the risk of osteonecrosis of the jaw."
Thacker agrees: "The risk of osteonecrosis of the jaw is overexaggerated. The Horizon Trial studied Reclast in 8,000 postmenopausal women and found no increase in osteonecrosis of the jaw."
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.