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Our weekly news column bringing the most current, non-biased health
information to the consumer. |
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March 11, 2008 |
A Publication of QVHD |
Osteoporosis Medications
By: V. Deborah Culligan, RN, MPH,
Deputy Director QVHD
You've seen the
commercials promoting new prescription drugs for all kinds of medical
ailments. Some of these ads make the drug sound like a miracle cure for
the condition from which the person suffers. However, towards the end of
the commercial, there is always a disclaimer which states “do not take
this drug if…” and the list of potential side effects or adverse
reactions scare the heck out of you! What seemed like a hopeful promise
becomes a potentially-risky proposition. You wonder why anyone would
ever chance taking such a drug! What you have to keep in mind is that
pharmaceutical manufacturers have to identify all possible and/or
potential side effects and possible complications for the protection of
the consumer and for protection from law suits. Any drug can have side
effects, but your health care provider must weigh the benefits of the
drug against the hazards of the drug. In the end, it is your decision.
Medications for osteoporosis are heavily marketed in the media. Along
with this marketing, there have been some reports of dangerous side
effects. Overall, millions of women (and some men) have taken drugs to
treat osteoporosis, with relatively few problems and great benefits.
As we age, bones lose mass faster than bone can be replaced, which leads
to brittle bones. This is called osteoporosis and is a major cause of
fractures. There are several drugs used to treat this condition. The
most common drugs used belong to a group known as oral bisphosphonates
and include Boniva (ibandronate), Fosamax (alendronate), and Actonel (risedronate.)
They work to keep protein in the bone. However, it is important to get
enough calcium and vitamin D for these medications to work properly. The
calcium helps to keep the protein in place in the bone, thereby building
strength and the vitamin D is critical in the ability to absorb the
calcium. These medications must be taken according to the instructions
or serious adverse affects can occur. (You may have heard that Boniva
can cause damage to the jawbone. However, this finding occurred in
patients who had cancer and were being given very high doses. Another
report found that Boniva weakened bones and caused unusual fractures in
nine patients, however, compared to the millions who take the drug
without such side effects, this number seems statistically
insignificant.)
The daily recommendation for calcium per day is 1,200 to 1,500 mg per
day for women and 1,200 mg per day for men. The daily recommendation for
vitamin D is for 400 international units (iu) per day for persons age
51-70 and 800 iu for those over age 70. Calcium may be obtained through
food, supplements or a combination of both. The form a supplement comes
in does not really make much difference in its absorption or its action,
so many health specialists recommend using cost as your criteria for a
supplement. (Get the most for the least!) But remember, it is critical
to get enough vitamin D to be able to utilize the calcium.
There are other medications used for treating and/or preventing
osteoporosis. The newest drug is administered one time per year
intravenously. It is zoledronic acid (belonging to the bisphosphonate
class) and marketed as Reclast. However, because it is so new and
because it may increase the incidence of atrial fibrillation, you will
not see it being widely used-yet. It is currently reserved for those
unable to oral therapy.
Calcitonin and Raloxifene (Evista) are sometimes used with other oral
medications. Teriparatide is very good at stimulating bone growth and
preventing fractures, but it is extremely expensive and must be given by
injection. Calcitriol is prescription strength vitamin D. Because the
blood must be monitored closely when using this drug, it is not widely
prescribed.
In addition to medications, there are some very important lifestyle
changes that you can make to prevent fractures caused by osteoporosis.
For example, weight-bearing exercise is important for increasing bone
density. Tobacco weakens bones, so quitting smoking with help to
preserve healthy bones. And remember, it is critical to get enough
calcium and vitamin D. The calcium without the vitamin D may not be
absorbed. For free written information on osteoporosis, treatment and
prevention, district residents can call QVHD or request on line,
www.qvhd.org.
| An Ounce of Prevention is a
publication of the Quinnipiack Valley Health District, located at
1151 Hartford Turnpike, North Haven, CT 06473. Telephone:
248-4528. An Ounce of Prevention is
written by V. Deborah Culligan. The articles are published in the following local newspapers, The Advisor &
Beth-Wood News.
The content is provided as health education and
information to help you make health decisions. It is not intended to
be legal or medical advice, or substitute for recommendations made
by your health care provider. Address all comments to the district
office. |
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