Antiresorptive medications affect the body's bone remodeling cycle by slowing or stopping the part of the process that involves breakdown of bone. This can both prevent the onset of osteoporosis and help treat the disease once it develops. These drugs include bisphosphonates, selective estrogen receptor modulators (SERMs), and estrogen therapy.
Weight loss and bone loss can sometimes go hand in hand.
Doctors know that women with anorexia, who severely restrict calories for a long time, are at increased risk for osteoporosis. The eating disorder interferes with hormones needed to maintain bone, not to mention the foods people need to build bone.
But what if you don’t have anorexia? What’s the relationship between osteoporosis and normal dieting? How do you know if you’re at risk for bone loss? What kind of dieting is safe for your...
Bisphosphonates include Actonel, Binosto, Boniva, Fosamax, and Zometa. Each of the bisphosphonates has been shown in clinical studies to reduce the risk of fracture from osteoporosis, although they are not all the same. Fosamax, for example, has been shown to reduce spine, hip, and wrist fractures, while Boniva has been shown to reduce spine fractures. Each drug has its advantages and disadvantages. Talk with your doctor about which might be best for you.
In addition, the FDA has approved another bisphosphonate, a drug known as Reclast, for the treatment of osteoporosis. Reclast is a once-yearly treatment, administered as a 15-minute IV injection.
These drugs are considered generally safe. However, a rare condition called osteonecrosis of the jaw has been linked to some bisphosphonates. This condition involves a wound that exposes bone and is difficult to heal, and can lead to infection. Most cases have occurred in people with cancer taking certain biphosphanates, and not in those with osteoporosis. Still, it is important to be aware of this condition and discuss it with both your doctor and dentist. A treatment plan and length of therapy needs to be discussed with you doctor as these guidelines are changing.
SERMs are designed to provide the beneficial effects of estrogen therapy, without the disadvantages that have been seen in some studies, such as increased risk of heart attack, breast cancer, and stroke. Only one SERM, Evista, has been approved for treating osteoporosis as of 2007, but others are currently in development. Evista has been shown to reduce the risk of spine fractures, but it's not yet known if it reduces fractures in other areas, such as the hip.
Estrogen therapy (alone or in combination with progestin or bazedoxifene) has been shown to decrease bone loss and reduce hip and spine fractures. It replaces the estrogen levels that drop drastically during menopause. Unfortunately, it has also been linked to an increased risk for heart attack, breast cancer, and stroke, so the FDA recommends that you consider other osteoporosis medications first.