Osteoporosis Diagnosis, Bone Density Testing, Prevention, Treatment, & Exercise
TREATMENT
Therapeutic options for osteoporosis include medications as well as calcium and vitamin D and exercise. Calcium and vitamin D alone is not enough in women after menopause or for some men. Various types of medications are available, and each one increases BMD and reduces fracture risk, some to a different degree than others.
FDA approved therapies for prevention and/or treatment of osteoporosis
- Fosamax "Alendronate" (oral 70mg once a week) with or without vitamin D 2800IU or 5600IU (Generic Alendronate has been available now since Feb 2008 but does not have vitamin D in it)
- Actonel "Risedronate" (oral 35mg once a week, monthly dose pack, which is two 75mg tablets on consequetive days once a month, or now one tablet (150mg once a month with only a 30 minutes wait after dosing))
- Boniva "Ibandronate" (oral 150mg once a month waiting an hour after dosing or 3mg intravenous over 30-60 seconds every 3 months)
- Evista "Raloxifene" (oral daily anytime)
- Miacalcin "Calcitonin" (nasal spray daily)
- Forteo "Teriparatide" or Parathyroid Hormone (subcutaneous injection daily for 2 years)
- Reclast "Zoledronic Acid" (5mg intravenous over 15-30 minutes once a year)
Sixty percent of men with osteoporosis and as many as 30% of women with osteoporosis have such a silent abnormality called a Secondary Cause of Bone Loss. If untreated, medication for osteoporosis may not be as effective in increasing BMD or bone strength and reducing fracture.
Forteo is parathyroid hormone now approved for over 4 years for the treatment of osteoporosis. Forteo is the first bone forming agent that stimulates 'osteoblasts', the cells making bone. It can be taken as a daily subcutaneous injection (like insulin is taken) for either 2 years or alternated every few months with an anti-resorptive agent such as Fosamax, Actonel, Boniva (Oral or IV), Evista or even estrogen, (though estrogen use is usually limited to the lowest dose for the shortest time needed for menopausal symptoms).
Since all of these FDA approved osteoporosis therapies may not be alike, it is important to talk with your medical provider or Drs Kohlmeier or Carey on follow up as to what is the best choice for you.
Forteo is expensive and has a Blackbox warning. Our teaching session gives you the information you need before starting Forteo. Twice a month we have an information session for our patients on Forteo at our downtown office. It is free and given by a nurse practicioner sponsored by Eli Lilly Co, which makes Forteo.
Deaconess Health & Education Center Class times are 3:00 - 5:00PM on the following dates:
- TBA
Discuss which therapy is best for you with your doctor. Before starting therapy, blood and urine tests (24 hour collection) may help determine why your bone density is low or why you have an increased fracture risk. These tests will look for hormone or calcium abnormalities as well as vitamin D deficiency for example, many of which can be reversed once discovered.
Exercise»
