Treatment of osteoporosis is aimed at preventing or reducing bone fractures and maintaining or increasing bone density. There are several treatments for osteoporosis, but prevention is still very important. Many of the treatment and prevention strategies for osteoporosis are similar.
Maintenance of good bone strength requires that you have a regular intake of calcium and vitamin D. Osteoporosis Canada recommends 1,000 mg of elemental calcium daily (diet plus supplements) for men and women between the ages of 19 and 50 years, and 1,200 mg for men and women over the age of 50 years. They recommend 400 IU to 1,000 IU of vitamin D daily for adults between the ages of 19 and 50 years who are not at high risk of osteoporosis, and 800 IU to 2,000 IU for both adults over the age of 50 and people at high risk of osteoporosis. Vitamin D supplements are widely available.
Osteoporosis Canada also recommends regular weight-bearing exercises and a healthy lifestyle with no smoking or excessive intake of alcohol.
Weight-bearing exercises (such as walking, weight training, or climbing stairs) play a role in strengthening bones and preventing fractures. Posture and balance can be improved through exercise and can significantly reduce the risk of bone fractures.
For teenagers and young adults under 30 years of age, weight-bearing exercises have the added benefit of increasing the peak bone mass (i.e. BMD). Beyond the age of 30, treatment can only prevent or delay the loss of BMD.
There are several medications that can be used to treat osteoporosis. Many of these treatments may also be used to prevent osteoporosis for people who are at high risk of developing it. The following are some of the osteoporosis medications available in Canada:
- bisphosphonates (e.g., alendronate, etidronate, risedronate, zoledronic acid): These are one of the main groups of medications that may be used to prevent and treat osteoporosis. These medications slow down bone loss and help repair bone, reducing the chance of fracture.
- selective estrogen receptor modulators (SERMs; e.g., raloxifene): These may also be used to prevent and treat osteoporosis in women.
- denosumab: Given as an injection, denosumab is part of a class of medications called RANK ligand inhibitors. It stops the breakdown of bone, helping to strengthen your bones and lowering the chances of fracture.
- testosterone: This is not recommended for the treatment of osteoporosis in most men. However, in some cases where osteoporosis in men is the result of hypogonadism, which is a condition of low levels of the male hormone testosterone, testosterone replacement therapy (androgen) may be used alone or with a bisphosphonate.
- hormone-replacement therapies (HRTs): A variety of HRTs are available for women who have reached menopause. Estrogen replacement helps to preserve bone and manage menopausal symptoms, but the therapy has a number of health risks. If you are taking or are considering taking HRT, talk to your doctor about the risks and benefits.
- parathyroid hormone analogues (e.g., teriparatide): This class of medication builds new bone faster than it breaks it down, and can be used to treat severe osteoporosis.
Two or more medications may also be used in combination to treat some cases of osteoporosis. In addition, doctors usually recommend that you continue to get enough calcium and vitamin D.
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For information on a given medication, check our Drug Information database. For more information on brand names, speak with your doctor or pharmacist.
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