Medications

Currently there are three primary medications used to treat osteoporosis:

• Fosomax
• Actonel
• miacalcin

Fosamax® (Alendronate Sodium)
Alendronate is approved for both the prevention (5 mg per day or 35 mg once a week) and treatment (10 mg per day or 70 mg once a week) of osteoporosis. In postmenopausal women with osteoporosis, alendronate reduces bone loss, increases bone density in both the spine and hip, and reduces the risk of both spine fractures and hip fractures.

Side effects are uncommon but may include abdominal or musculoskeletal pain, nausea, heartburn, or irritation of the esophagus. Like all bisphosphonates, alendronate must be taken on an empty stomach. The manufacturer strongly recommends taking this medication with a full glass of water first thing in the morning and then waiting at least one-half hour before the first food, beverage, or medication of the day. To minimize side effects, individuals must remain in an upright position for at least one half hour after taking this medication.

Actonel® (Risedronate Sodium)
Risedronate is also from the bisphosphonate family. Taken daily, 5 mg of risedronate slows bone loss, increases bone density and reduces the risk of spine and non-spine fractures. Risedronate must be taken on an empty stomach, first thing in the morning with a glass of plain water. The manufacturer strongly recommends that individuals remain upright and refrain from eating, drinking or taking other medications for at least one half hour after taking risedronate.

Few side effects were reported, and these were similar to those reported with sugar pills (placebos) and included stomach upset, constipation, diarrhea, bloating, gas or headache.

Risedronate also is approved for use by men and women to prevent and/or treat steroid-induced osteoporosis that results from long-term use of medications such as prednisone or cortisone.

Miacalcin® (Calcitonin)
Calcitonin is a naturally occurring hormone involved in calcium regulation and bone metabolism. In women who are at least 5 years beyond menopause, calcitonin slows bone loss, increases spinal bone density, and, according to anecdotal reports, relieves the pain associated with bone fractures. Calcitonin reduces the risk of spinal fractures but does not appear to have a significant effect on non-vertebral fractures, (i.e. hip). Studies on fracture reduction are on-going. Because calcitonin is a protein, it cannot be taken orally as it would be digested before it could work. Calcitonin is available as an injection (50-100 IU daily) or nasal spray (200 IU daily). While it does not affect other organs or systems in the body, injectable calcitonin may cause an allergic reaction and unpleasant side effects including flushing of the face and hands, urinary frequency, nausea, and a skin rash. The only side effect reported with nasal calcitonin is a runny nose.