Top Osteoporosis Drugs: Safety and Side Effects

Saturday, 28 Dec 2013 07:52 PM

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Although the common belief is that our bones have formed by adulthood, bones are a growing tissue that constantly replaces older tissue and renews itself. The process of renewal or remodeling cycle consists of two stages – bone breakdown or removal (also called resorption) and bone formation. These two processes take place in sequence and balance each other. However, due to aging and menopause, an imbalance occurs in the process that results in bone loss and osteoporosis. 
 
Antiresorptive drugs slow down the breakdown part of the osteoporosis cycle. Bone density increases in this osteoporosis treatment as the medication slows down the breakdown process but the bone formation process continues. This class of drugs prevents bone loss and lowers the risk of breaking bones and osteoporosis. Drugs in this category include bisphosphonates, calcitonin, denosumab, estrogen, and estrogen agonists/antagonists.

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Side effects for all bisphsphonates, like alendronate, ibandronate, risedronate and zoledronic acid, may include bone, joint or muscle pain, bone loss in the jaw (osteonecrosis), abnormal heart rhythm (atrial fibrillation). Side effects of the oral tablets include nausea, difficulty in swallowing, heartburn, irritation of the esophagus, and gastric ulcers. Side effects of this intravenous osteoporosis drug include flu-like symptoms, fever, headache, and pain in muscles and joints that occurs within the first two or three days and usually does not recur thereafter during drug treatment. Inflammation of the eye is also among the rare side effects of these osteoporosis drugs. Among other rare side effects of this treatment are fractures of the upper femur or thighbone while taking these osteoporosis medications.
 
The safety and efficacy of these osteoporosis medications are up to five years. Thereafter, eventual bone loss continues. These drugs are not a safe treatment option for osteoporosis patients with severe kidney disease and osteoporosis patients with low blood calcium.

Calcitonin is a synthetic hormone given to women suffering from osteoporosis who are at least five years past their menopause. This medication slows bone loss and increases bone density of the spine. Treatment can be administered as a nasal spray or as an injection. Side effects of this osteoporosis medication are a runny nose, back pain, headache, and nosebleeds. The injectable drug may cause side effects such as flushing of the face and hands, increased frequency of urination, nausea, and skin rash.

Denosumab is a medication that lowers the blood calcium levels. Decreased calcium levels could result in twitches, cramps, or spasms in the muscles or numbness or tingling in the fingers or toes or around the mouth. The side effects of this medication include fever, chills, red and swollen skin, hot and sore skin, severe pains in the abdomen, pain or burning sensation while passing urine, or frequently passing small amounts of urine.

Estrogen therapy treatment has the side effects of vaginal bleeding, breast tenderness, and possibility of gallbladder disease. These medications also increase the risk of endometrial cancer, strokes, heart attacks, and venous blood clots.

Anabolic drugs, such as parathyroid hormone, increase the rate of bone formation and therefore rebuilds bone and lowers the risk of breaking bones due to osteoporosis. Drugs in this category of treatment include teriparatide. The side effects of the teriparatide medication include leg cramps and dizziness. This medication is safe for up to two years of use. Teriparatide is not safe for patients of osteoporosis with Paget’s disease, growing children, people who have had radiation treatment, people with hyperthyroidism, and those who have any cancer that has spread to the bone.
 
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