Osteoporosis

Current Medication Guidelines

Categories

Biophosphonates:

1. Boniva (the Sally Field drug)

2. Reclast

3. Fosamax

4. Actonel

Selective Estrogen Receptor Modulator

1. Evista

Natural Hormone

1. Calicitonin

Others

1. Prolia

2. Forteo

Biophosphonates

• Bisphosphonates are antiresorptive medicines, which means they slow or stop the natural process that dissolves bone tissue, resulting in maintained or increased bone density and strength. This may prevent the development of osteoporosis. If osteoporosis already has developed, slowing the rate of bone thinning reduces the risk of broken bones.

• Bisphosphonates may be taken by men or women.

• Studies show that bisphosphonates increase bone thickness and may lower the risk of fractures.1

Biophosphonates

• Heartburn and irritation of the tube that connects the throat to the stomach (esophogus), if you are taking bisphosphonate pills. These side effects can usually be avoided by following the instructions for taking your medicine.

• Headache, constipation, diarrhea, and passing gas; and muscle and joint pain, if you are taking intravenous (IV) bisphosphonate shots.

Common side effects

Contraindicationsfor

Biophosphonates• Not usually given to patients with kidney disease. Kidney function should

be tested prior to beginning drug regimen

• Tell physician if you have ever been diagnosed with GastroesophogealReflux Disease (GERD) or if you have had a recurrent history of heartburn

• Serious problems with bone healing, particularly after dental surgery, have been found in some people who are taking bisphosphonates. If you are taking bisphosphonates and need dental surgery, talk with your doctor

• If you are pregnant, breast-feeding, or planning to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breast-feeding, or planning to get pregnant.

Selective Estrogen Receptor ModulatorSERM

Evista-

• Raloxifene is used to prevent and treat bone loss (osteoporosis) in women after menopause. Maintaining strong bones by slowing bone loss helps to reduce the risk of fractures.

• Raloxifene may also lower the chance of getting a certain type of breast cancer (invasive) in women after menopause.

SERM Side Effects

• Hot flashes, sweating, or leg cramps may occur

• Raloxifene may infrequently cause stroke or serious blood clots to form in the legs, lungs, or eyes

For a complete list of side effects please visit the Drug Website

Contraindications for SERM

• Raloxifene may cause serious blood clots to form in the legs or lungs. Tell your doctor if you have history of blood clots (e.g., deep venous thrombosis, pulmonary embolism). Some risk factors include tobacco use, alcohol use, having high cholesterol/diabetes, or history of heart disease.

• This medication is not recommended for use in women before menopause. It should not be used in children.

• It is not known whether this drug passes into breast milk. Breast-feeding while using this medication is not recommended.

Natural Occurring Hormone

Calcitonin

Calcitonin is a naturally occurring hormone. It helps regulate calcium levels in your body and is involved in the process of bone building. When taken by shot or nasal spray, it slows the rate of bone thinning. It also relieves pain that occurs when the bones in the spine (vertebrae) break and collapse on top of each other (spinal compression fracture).

Side Effects of Natural Occurring Hormone

Common side effects include:

Common side effects of injected calcitonin include:

• Nausea with or without vomiting

• Skin irritation at the injection site

• Skin redness (flushing)

Common side effects of nasal calcitonin include:

• Runny nose

• Nasal discomfort, sores, or redness

• Nosebleeds

Contraindications to Natural OccuringHormone

Talk to your physician about any concerning Past Medical History you may have

Because it is considered a Natural Occurring Hormone there are very few reactions to this medication

Others

Prolia• Is injected under the skin, usually every 6 months.

• Slows the formation and action of cells called osteoclasts. These are the cells that naturally break down bone. By slowing down the osteoclasts, it allows bone to become more dense (thicker).

Forteo• Teriparatide is used to treat bone loss (osteoporosis) in people who have a

high risk of getting fractures. It is similar to a natural hormone in your body (parathyroid hormone). It works by increasing bone mass and strength. This effect helps to decrease the risk of getting a fracture.

Side Effects of Other

Prolia• Rash

• Back pain

• Other bone, joint, or muscle pain

Forteo• Dizziness or fast heartbeat may occur within 4 hours after using this

medication. This effect should go away after several doses as your body adjusts to the medication

• Muscle cramps/spasms or pain/swelling/bruising at the injection

• fainting, constipation, unusual tiredness, mental/mood changes (such as confusion)

Contraindications to Other

Prolia• Problems with bone healing, particularly after dental surgery, have been

found in some people who are taking Prolia. If you are taking Prolia and need dental surgery, talk with your doctor.

• People who have very low calcium (hypocalcemia) should not take Prolia

Forteo• Do not take if you have a history of bone disorders (such as bone cancer),

high level of calcium in the blood (hypercalcemia), kidney stones.

• Do not use during pregnancy or when breastfeeding