Boning Up on Bone Drugs

Can a drug intended to prevent fractures cause them? The scoop on osteoporosis meds.

by Katharine Davis Fishman
Photograph: Photo: Coolife and Carole & Pauline

Luckey says the field may evolve so that different medications are prescribed at different stages of life. One scenario might involve a patient taking a low dose of estrogen close to menopause to protect bones and help with menopausal symptoms, followed by Evista to reduce the risk of breast cancer and osteoporosis, and then use of a bisphosphonate, if needed, later in life when hip-fracture prevention becomes increasingly important.

The bottom line: Experts agree that bisphosphonates prevent a lot of fractures in elderly patients with severe osteoporosis, and more of these people should be getting the drugs. If you are in your fifties and have a mother in her eighties, most likely she is a better candidate for bisphosphonate therapy than you are. Before taking these drugs, consult with your doctor to be absolutely sure you have real osteoporosis or a high FRAX score. If you do begin this course of therapy, get checked after three to five years to see if you still need it. As Dell observes, “You don’t give tumor drugs to prevent a tumor, and you shouldn’t give an oral bisphosphonate to prevent osteoporosis in someone who doesn’t have osteoporosis. This is a potent medication, not to be used by people who don’t need it.”

Originally published in the June 2010 issue of

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