Treatments for Osteoporosis

 

If you are found to have low bone density or osteoporosis, putting you at higher risk of fractures, you will usually be recommended to start the treatments below. In certain cases where other medications such as steroids can increase your risk of developing osteoporosis, the same treatments are used.

 

Calcium and Vitamin D supplements

If you are struggling to get enough calcium each day via your diet, then a supplement is beneficial. We usually give this along side vitamin D as they are both required to support bone health.

 

The most common tablets prescribed are:

 

If your calcium intake meets the recommended requirements of 700mg daily, then vitamin D can be prescribed alone such as Fultium D3- 1 tablet daily.

 

Bisphosphonates

 

What are Bisphosphonates? 

Bisphosphonates are a group of drugs that are used to reduce the risk of broken bones. Bones are constantly being broken down and built back up by special bone cells called osteoblasts and osteoclasts. This helps remodel the bone. When this process is out of balance, bones can become thin and weak as more bone is broken down than built back up. Bisphosphonate drugs are medications that alter this balance and prevent bone from being broken down and increase bone strength.

 

What are bisphosphonates used for?

Bisphosphonates are used to strengthen bones and prevent fractures in weak bones. They are primarily used for osteoporosis and can also be prescribed for people with Paget’s disease.

 

How are they taken?

Bisphosphonates come in a couple of different forms, they are most commonly taken as tablets, but they can be given intravenously- in a drip via a vein. They are usually prescribed along side calcium and vitamin D supplements.

 

Tablets:

 

Intravenous drips

 

Side effects

There are a few possible side effects that can occur with taking bisphosphonate drugs, these are:

 

In addition to the possible side effects above, getting the drip form, zolendronic acid has 2 other possible side effects to be aware of:

 

Cautions of use

Contraindications with other conditions

Operations

During pregnancy and breastfeeding

Alcohol

Vaccinations

 

Denosumab

 

What is Denosumab?

Denosumab is treatment for osteoporosis that helps prevent bone loss. Bones are constantly being broken down and built back up by special bone cells called osteoblasts and osteoclasts. This helps remodel the bone. When this process is out of balance, bones can become thin and weak as more bone is broken down than built back up. Denosumab is a protein called an antibody that blocks a protein that’s involved in stimulating bone resorption, therefore reducing bone loss.

 

How is it taken?

Denosumab is an injection that is given into the fat between the skin and muscle (subcutaneous) every 6 months. It is continued long-term.

It is important to take calcium and vitamin D supplements whilst you are receiving these injections.

Although denosumab can be given to patients with lower kidney functions, you will need to get your bloods checked for your kidney function, calcium and vitamin D levels before each injection.

 

Side effects

There are a few side effects that some patients can experience whilst taking denosumab, these include:

 

Cautions of use

Contraindications with other conditions

During pregnancy and breastfeeding

Alcohol

Vaccinations

 

 

Teriparatide

 

What is Teriparatide?

Teriparatide is a man made version of parathyroid hormone. Parathyroid hormone is a hormone that is naturally produced by the body to help regular calcium. It is usually produced by the parathyroid glands, which are small glands that are found in the neck.

Parathyroid hormone regulates calcium and reduces the risk of broken bones in osteoporosis.

Bones are constantly being broken down and built back up by special bone cells called osteoblasts and osteoclasts. This helps remodel the bone. When this process is out of balance, bones can become thin and weak as more bone is broken down than built back up. Parathyroid hormone increases the amount of bone that it built up, helping to strengthen bones.

It is often used in patients who have lots of spinal fractures and in those where other treatments haven’t been as effective.

 

How is it taken?

Teriparatide is given as a daily injection. It is a subcutaneous injection, meaning it is given into the layer of fat between the skin and muscle. The duration of treatment is usually for 2 years.

It is important to ensure that you are getting enough calcium and vitamin D whilst taking teriparatide, this may need to be as supplements.

 

Side effects

There are a few possible side effects that some people can experience whilst taking teriparatide, they usually settle down once your body is used to the injections, these include:

 

 

Cautions of use

Interactions with other medications

Contraindications with other conditions

During pregnancy and breastfeeding

Alcohol

 

Useful Links

Versus Arthritis: http://www.versusarthritis.org

Royal Osteoporosis society: http://www.theros.org.uk