Drugs for osteoporosis (used to treat and prevent fractures)
If you’re diagnosed with osteoporosis following a low-impact fracture, then the fracture will need to be treated first. The next step is to begin treatment to reduce your risk of further fractures.
Treatment of fractures
Most fractures are first treated in A&E. Unless you have a vertebral compression fracture, you'll probably have a cast on the affected area to stop it moving and allow the fracture to heal. In some cases the fracture may need to be manipulated by a specialist first or it may need surgical fixing.
It's likely that you'll need pain relief medications while the fracture heals, for example:
- painkillers (analgesics), such as paracetamol, codeine and occasionally morphine
- non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen.
Prevention of fractures
A number of specific treatments are available to reduce the risk of further fractures. You're likely to have a bone density scan before you start treatment, although this may not be needed, for example if you're 75 or over. Once you've started treatment your bone density, and possibly other aspects of your health, may be monitored.
Treatments to reduce the risk of fractures work either by slowing down the breakdown of old bone material, or by speeding up the process of bone renewal, or a combination of both.
Bone renewal is a slow process so it's important to continue treatment as your doctor advises – even though you won't be able to feel whether it's working.
Because longer-term treatment can sometimes have side-effects your doctor may suggest a break from your treatment after 3–5 years. The benefits of osteoporosis treatment last a long time so these won't be lost if your doctor does suggest a 'treatment holiday'.
Treatments to reduce the risk of osteoporotic fractures include:
- calcium and vitamin D
- bisphosphonates (alendronate, risedronate, ibandronate, etidronate, zoledronate)
- teriparatide and parathyroid hormone
- hormone replacement therapy (HRT).
Another drug sometimes used to treat osteoporosis, strontium ranelate, was discontinued in August 2017. If you are currently taking strontium ranelate you should arrange to see your doctor to discuss other treatment options that may be suitable for you.