If you have osteoporosis, you should work with your health care provider to plan a treatment program that meets your needs. There are a variety of prescription medications available to slow bone loss and help prevent fractures caused by osteoporosis. The following medications are approved by the U.S. Food and Drug Administration for prevention and/or treatment of osteoporosis. The FDA can also provide information on approved medications.

• Three bisphosphonates, Fosamax, Actonel, and Boniva (brand names) are now available to slow or stop bone loss and reduce fracture risk. They may be good choices for women who can't, or won't, take HRT. Fosamax and Actonel are available in once per week doses. To use bisphosphonates you must follow strict rules and not lie down eat or drink for 30-60 minutes. Some people find this inconvenient or have stomach pain using the medication. Studies show that bisphosphonates reduces spinal fractures after just one year of treatment. Boniva is the latest approved drug and is taken once per month.
• Parathyroid Hormone (PTH): teriparatide (Forteo) has been shown to reduce the incidence of vertebral fractures. It may be used when other drugs are considered unsuitable and when there is a high risk of fractures.
• Hormone replacement therapy, or HRT, uses a combination of estrogen and other hormones to protect
  women from bone loss. This treatment does increase bone density and is low cost. Some studies show that long-term use may increase the risk of breast cancer, but there may be a decreased risk of Alzheimer's disease.
• Calcitonin, or Miacalcin, is a hormone that helps your body use calcium. It also seems to reduce bone loss and prevent spine fractures. It is taken as a nasal spray so it is easy to use. It has almost no side effects, but is considered less effective than HRT or Fosamax.
• Selective estrogen receptor modulators (SERMs) like Raloxifene is a medication developed to provide the benefits of estrogens without some of their drawbacks. Raloxifene prevents bone loss like a low dose of estrogen. It may increase the risk of blood clots and won't eliminate hot flashes, but may reduce the risk of breast cancer.
• Several additional prescription medications are under investigation.

For more details on the Women's Health Initiative and The National Institute of Health July 2002 press release on HRT and risk of cardiovascular disease and breast cancer at: http://www.nih.gov/news/pr/jul2002/nhlbi-09.htm. The complete Journal of American Medical Association article about these study results can be found at: http://jama.ama-assn.org/issues/v288n3/ffull/joc21036.html.

If you have osteoporosis, or are at high risk for the disease, your health care provider can help you plan a treatment program. They can help you decide what medications would be the best choices for you, and review the benefits, side effects, and how these medications interact with other medications you are taking for other conditions. In addition to medicine, your treatment plan should include a healthy, calcium-rich diet and regular weight-bearing activity that promotes healthy bones. Bone density scans, completed before a treatment program starts, and repeated on a regular basis, can help check whether the treatment program is working.

To get full benefit from your prescription medications, it is important to take them exactly as directed and for as long as your doctor prescribes.

Questions to ask your doctor
Your doctor will give you information about your condition, but you should make sure that you clearly understand the benefits and risks of any treatment he or she recommends. It may help to take a list of questions to your appointment, and talk to your doctor about any concerns you have. Discuss any problems you are having with treatment, and don't stop any medication without talking to your doctor about it. You may wish to ask:

• What are the benefits of the treatment you recommend?
• Will I notice any changes while taking the medication?
• What are the side effects of treatment?
• What should I do if I have any side effects?
• What changes can I make to my lifestyle to help lower my risk of fractures?
• What will happen if I don't have any treatment?
• How much do the treatments/tests cost?
• When should I return for another appointment?
• How long should I take the medication?
• Where can I get more information about osteoporosis?
  
  

*Brand names are only provided as examples and not meant as endorsements.

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