The main medicines for osteoporosis are bisphosphonates, monoclonal antibodies or hormones (such as estrogen or testosterone). These substances help slow bone loss or maintain bone density, reducing the risk of fractures, which is very common in osteoporosis.
Osteoporosis is a disease in which there is a decrease in bone mass, which makes the bones more fragile, increasing the risk of fracture. This condition is more common in menopausal women or in men with hypogonadism, for example.
The treatment of osteoporosis with medicines must be guided by a gynecologist or orthopedist, as the use of medicines causes several side effects such as respiratory infections, pelvic pain, dizziness or mood disorders. See how osteoporosis is treated.
The main remedies that may be recommended by your doctor for the treatment of osteoporosis are:
1. Bisphosphonates
Bisphosphonates are the most recommended medicines for the treatment and/or prevention of osteoporosis, both in women and men. These medications work by inhibiting bone resorption, helping to maintain bone density and reduce the risk of fracture.
Some examples of bisphosphonates are alendronate, ibandronate or risedronate, which can be used in tablet form, and should be taken on an empty stomach, 30 to 60 minutes before breakfast, with a glass of water, depending on the type of bisphosphonate.
Another relatively common bisphosphonate is zoledronic acid, however, this medication is only used in hospitals, as it must be applied directly into the vein, by a nurse and in accordance with medical advice.
Side effects: Bisphosphonates taken orally can cause nausea, heartburn, poor digestion, esophageal irritation, problems swallowing, stomach pain, diarrhea or constipation. Zoledronic acid, applied into a vein, can cause fever, headache or muscle pain.
2. Monoclonal antibodies
Monoclonal antibodies, such as denosumab, act by reducing bone resorption and are indicated for the treatment of osteoporosis in postmenopausal women or in men with prostate cancer who have an increased risk of bone fractures, bone cancer or the development of metastases. bones.
Denosumab is generally recommended when other treatment options for osteoporosis have not been effective, and should be applied subcutaneously, that is, as an injection under the skin of the thigh, arm or abdomen, once every 6 months, as directed. doctor.
Another monoclonal antibody that can be used to treat osteoporosis is romosozumab, indicated for postmenopausal women at high risk of fracture, or who are intolerant to other medications or when other treatments have not been effective. This remedy can be found in the form of an injection to be applied under the skin of the thigh, abdomen or forearm, once a month, or as prescribed by a doctor.
Side effects: The most common side effects that may occur during treatment with denosumab are urinary tract or upper respiratory tract infection, musculoskeletal pain or constipation. Romosozumab can cause joint pain, respiratory infections, cough, headache or neck pain, swelling in the hands, ankles or feet, and muscle spasms.
3. Estrogen therapy
Estrogen therapy is a type of treatment that replaces the estrogen hormone and is indicated to promote an increase in bone mineral density and help prevent vertebral fractures in postmenopausal women.
The main estrogen therapy drug for osteoporosis is raloxifene, which should only be used with medical advice, due to the high risk of developing blood clots, in addition to heart disease and breast cancer.
Another remedy that can be used in estrogen therapy is tibolone, indicated as hormone replacement therapy in menopause, which in addition to being used to alleviate menopausal symptoms, also helps maintain bone density and reduces the risk of fractures. However, this treatment is not always recommended, because it slightly increases the risk of breast, endometrial, ovarian cancer and stroke.
Side effects: Raloxifene can cause side effects such as hot flashes or hot flashes, formation of stones in the bile ducts, swelling of the hands, feet and legs and muscle spasms. Tibolone can cause pelvic and abdominal pain, vaginal discharge and bleeding, genital itching, endometrial hypertrophy, breast tenderness, vaginal candidiasis, changes in the morphology of cells in the cervix, vulvovaginitis and weight gain.
4. Testosterone Therapy
Testosterone therapy may be indicated for the treatment of osteoporosis in men at high risk for fractures when combined with other osteoporosis medications.
Testosterone can also be used alone, especially in cases where the use of other medications is contraindicated and when testosterone levels are less than 200 ng/dL, or when the man shows signs or symptoms of androgen deficiency or hypogonadism. Know how to identify the symptoms of hypogonadism.
Side effects: The most common side effects that may arise with the use of testosterone are mood disorders, dizziness, a feeling of numbness or tingling in some part of the body, amnesia, headache, high blood pressure, diarrhea and hair loss.
5. Synthetic polypeptide hormone
Synthetic polypeptide hormones, such as calcitonin, act by regulating calcium levels in the blood, increasing the deposit of calcium in the bones, which helps in the formation of stronger bones. This type of hormone is indicated for postmenopausal women, when other treatments for osteoporosis are not possible.
Calcitonin can be used as an injection applied to the muscle or under the skin, but it can also be used as a nasal spray, as per medical advice.
Side effects: The most common side effects of calcitonin are dizziness, headache, taste changes, sudden hot flashes or facial or neck redness, nausea, diarrhea, abdominal pain, bone and joint pain, or tiredness.
6. Parathyroid hormone
Parathyroid hormones, such as teriparatide, act by stimulating bone formation and increasing calcium reabsorption, and are indicated for the treatment of osteoporosis in postmenopausal women or in men at high risk of fractures.
Teriparatide is available as an injection to be applied under the skin, on the thigh or abdomen, as per medical advice, and the treatment time should not exceed 2 years.
Side effects: The most common side effects of teriparatide are increased cholesterol, depression, neuropathic leg pain, feeling faint, irregular heartbeat, shortness of breath, sweating, muscle cramps, tiredness or chest pain.
How to complement osteoporosis treatment
The best way to complement the treatment of osteoporosis is to increase the consumption of foods rich in calcium, which is the main mineral that forms bone mass, such as cashews, blackberries or papaya, which can be consumed in their natural form or in juices, for example. See how to consume foods rich in calcium.
Furthermore, to ensure the best effect of calcium-rich foods, your doctor may also recommend taking a vitamin D supplement, as vitamin D is important to ensure that the calcium ingested can be absorbed by the bones. Learn more about calcium and vitamin D supplements.
