Osteoporosis is a metabolic bone lesion caused by a variety of causes in which bone tissue has normal calcification and a normal ratio of calcium salts to matrix, and is characterized by a decrease in the amount of bone tissue per unit volume. In most osteoporosis, the decrease in bone tissue is mainly due to increased bone resorption and is characterized clinically by skeletal pain and easy fracture.
I. What is the role of anti-osteoporosis drugs?
If you have osteoporosis or are at high risk of fracture, your doctor may prescribe the following medications for you.
1. medications to reduce bone loss.
2. medications to increase or maintain bone density.
3. medications to reduce the risk of fracture.
Your doctor or nurse will tell you the dosage and frequency of these medications.
What medications do I need to take?
There are many different kinds of anti-osteoporosis medications. Your doctor will choose the most appropriate medication for you.
Bisphosphonates – Bisphosphonates are preferred by most patients with osteoporosis. If they are not as effective or if side effects occur, other medications will be chosen.
Bisphosphonates are available in both oral and injectable forms. One oral tablet per week is sufficient for most patients. If your doctor prescribes an oral bisphosphonate formulation, you must take the medication as prescribed. If you do not follow your doctor’s instructions, the medication may irritate your throat or stomach. When taking most bisphosphonates, you must.
take the medication in the morning on an empty stomach
Take the tablets with about 250 ml of water and then do not eat or drink anything else for 30 minutes to 1 hour (depending on the drug you are taking). Do not lie down for 30 minutes after taking the medication (i.e. you must sit or stand).
There is an oral formulation of bisphosphonates, a sodium lisperdal phosphate extended-release agent (trade name: Antrim), which is taken differently than the others. This drug needs to be taken with 250 ml of water after a meal.
Estrogen analogs – These drugs are called selective estrogen receptor modulators (or “SERMs”) and work similarly to estrogen. Estrogen can prevent bone loss. SERMs can prevent bone loss in the same way that estrogen does, and some may also reduce the risk of breast cancer in women.
Hormonal drugs – These drugs are also called “hormone replacement therapy” or “HRT”. After menopause, a woman’s hormone levels decrease. Some women can replace these hormones with HRT, which can also fight osteoporosis.
Menopausal women are less likely to use hormone replacement therapy to treat osteoporosis because other medications are more effective in fighting osteoporosis. However, HRT can be used for women who have menopausal symptoms (such as hot flashes) but cannot take other anti-osteoporosis medications.
Non-menopausal women can take birth control pills to prevent osteoporosis. Some men have osteoporosis because they do not have enough “testosterone” in their bodies, and if this is the case, their doctor can prescribe testosterone to treat osteoporosis.
Parathyroid hormone (PTH) – Parathyroid hormone is a synthetic hormone that can also be produced naturally by the body. PTH is very powerful but expensive, and is only used in patients with severe osteoporosis.
Denosumab – Denosumab is a monoclonal antibody that blocks a protein in the body that causes bone destruction. By blocking this protein, denosumab may reduce the chance of bone loss and bone destruction. Your doctor may give you denosumab if other anti-osteoporosis drugs have a lot of side effects or don’t work. The drug may also be chosen for patients with renal insufficiency. The drug is administered by subcutaneous injection every 6 months. Because Denosemide is newer than other anti-osteoporosis and it will be many years before doctors know its safety, they do not prescribe it often.
Calcitonin – Calcitonin is a hormone that is naturally produced by the body. Doctors can prescribe synthetic calcitonin to treat osteoporosis. It is not as effective as other anti-osteoporosis drugs, but it can relieve pain in patients with crest fractures. When used for crestal fractures, calcitonin is only used for pain relief (not for more than 6 months). If you are using calcitonin, after 6 months you may want to switch to another anti-osteoporosis medication.
How long do I need to take anti-osteoporosis medication?
If you have a high risk of fracture, you can take it for many years. If you are not at high risk of fracture, you can take it for one year and then stop taking it. Your doctor will check your bone density to make sure you are not losing too much bone. If you stop taking the drug, you may be able to take it again later.
Fourth, is there anything else I should know about osteoporosis medications?
Some people may have heard that long-term use of bisphosphonates can increase the risk of fracture in certain bones. This is true, but the incidence is extremely low. The risk of fracture from osteoporosis is much higher than the risk of fracture from the bisphosphonates you take.
If you take anti-osteoporosis medication, your doctor will check regularly to see if the medication is working. If the medication is not working, you may need to switch to another anti-osteoporosis medication.