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How Prescription Medications Affect Bone Health

close up of a variety of prescription pills scattered over a prescription notepad

Our bones are the very support system of our bodies, and keeping them in optimal shape is essential to maintaining physical strength. However, there are some prescription drugs that may negatively affect bone health. Identifying these drugs is an important step in maintaining bone health. Listed below are some common prescription medications that can have a negative impact on bone health. It is important to note that just because a certain medication is on the list does not mean that it should be eliminated entirely, just that other measures may need to be taken to ensure the negative effects are minimized.

 

Corticosteroid Drugs:

Corticosteroid drugs are steroids used to reduce inflammation in the body. They are most commonly used to treat rheumatoid arthritis, asthma, and ulcerative colitis. Two common types of this drug are cortisone (Cortone), and prednisone which includes Deltasone, Meticorten, Orasone, and Prednicot. Corticosteroid drugs slow down bone formation while also increase bone resorption, which is process in which bone is lost.  

 

Anti-Cancer Drugs:

Anti-cancer drugs, specifically those designed to fight breast cancer, lower estrogen levels in the body to fight cancer. However, estrogen is the main hormone that stops bone resorption. Generally speaking, most doctors will prescribe vitamin D or a bone maintenance drug to combat the effects of an estrogen-inhibiting drug.

 

Antidepressant Drugs:

Different antidepressants, such as Celexa, Prozac, Paxil, and Zoloft have been found to possibly decrease bone density in some patients. It is recommended to verify your dosage with your doctor and supplement calcium and vitamin D as needed.

 

GERD Drugs:

Certain GERD drugs such as: Nexium, Prevacid, Prilosec, and Zegerid increases the risk for fractures in the hip, wrist, and spine, although the cause of this is not immediately known. Other GERD drugs such as: Tagamet, Calmicid, Fluxid, Mylanta AR, Pepcid, Tritec, and Zantac are believed to be more bone friendly.

 

Diabetes Drugs:

A specific kind of diabetes drug, thiazolidinediones which include: Actos and Avandia, have been shown to have a negative effect on bones. It is not clear what this effect is currently, however people with bone density problems are recommended to speak with their doctor about an alternative medication.

 

Bone-Maintenance Drugs:

Yes, you read that right. Certain types of medications used to treat osteoporosis MAY cause bone loss in rare cases after long-term use. If this occurs, your doctor will switch you off that medication promptly. This issue is most commonly seen in bisphosphonate drugs which include: Binosto, Fosamax, Boniva, Actonel, Atelvia, and Reclast. If these drugs are causing any issues, there are alternatives that can be used such as: Prolia, Evista, Forteo, and hormone replacement therapy. Hormone replacement therapy has been found to preserve bone mass and prevent fractures, however it has its own set of risks and may not always be the best treatment.

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    Luc Teurlings, MD The team at Space Coast Orthopedics is proud to provide the communities of Merritt Island, FL, and the entire space coast with exceptional orthopedic services. From physical therapy to surgical solutions for concerns affecting joints resulting from sports injuries, natural aging, or trauma, we work with our patients to restore and maintain an active life.
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