Bone disorder drugs
Complete list of drugs used to treat
arthritis.
Definition of Bone disorder drugs
Bone disorder drugs are medicines used to treat diseases that weaken the bones.
Purpose for Bone disorder drugs
The drugs described here are used to treat or prevent osteoporosis (brittle bone
disease) in women past menopause as well as older men. They also are used prescribed for
Paget's disease, a painful condition that weakens and deforms bones, and they are used to
control calcium levels in the blood.
Bone is living tissue. Like other tissue, bone is constantly being broken down and
replaced with new material. Normally, there is a balance between the breakdown of old bone
and its replacement with new bone. But when something goes wrong with the process, bone
disorders may result.
Osteoporosis is a particular concern for women after menopause, as well as for older
men. In osteoporosis, the inside of the bones become porous and thin. Over time, this
condition weakens the bones and makes them more likely to break. Osteoporosis is four
times more common in women than in men. This is because women have less bone mass than
men, tend to live longer and take in less calcium, and need the female hormone estrogen to
keep their bones strong. If men live long enough, they are also at risk of getting
osteoporosis later in life. Once total bone mass has peaked--around age 35--all adults
start to lose it. In women, the rate of bone loss speeds up during menopause, when
estrogen levels fall. Bone loss may also occur if both ovaries are removed by surgery.
Ovaries make estrogen. Hormone replacement therapy is one approach to preventing
osteoporosis. However, not all people can use hormone replacement therapy. Bone disorder
drugs are a good alternative for people who already have osteoporosis or who are at risk
of developing it. Risk factors include lack of regular exercise, early menopause, being
underweight, and a strong family history of osteoporosis.
Description of Bone disorder drugs
Bone disorder drugs are available only with a physician's prescription and come in
tablet, nasal spray, and injectable forms. Commonly used bone disorder drugs are
alendronate (Fosamax), calcitonin (Miacalcin, Calcimar), and raloxifene (Evista).
Raloxifene belongs to a group of drugs known as selective estrogen receptor modulators
(SERMs), which act like estrogen in some parts of the body but not in others. This makes
the drugs less likely to cause some of the harmful effects that estrogen may cause. Unlike
estrogen, raloxifene does not increase the risk of breast cancer. In fact, research
suggests that raloxifene may even reduce that risk.
Recommended dosage of Bone disorder drugs
Alendronate
For osteoporosis
The usual dose is 10 mg once a day. Treatment usually continues over many years.
For Paget's disease
The usual dose is 40 mg once a day for 6 months.
This medicine works only when it is taken with a full glass of water first thing in the
morning, at least 30 minutes before eating or drinking anything or taking any other
medicine. Do not lie down for at least 30 minutes after taking it because the drug can
irritate the esophagus, the tube that delivers food form the mouth to the stomach.
Calcitonin
Nasal spray
The usual dose is 1 spray into the nose once a day. Alternate nostrils, spraying the
right nostril one day, the left nostril the next day, and so on.
Injectable
The recommended dosage depends on the condition for which the medicine is prescribed
and may be different for different people. Check with the physician who prescribed the
medicine or the pharmacist who filled the prescription for the proper dosage.
Raloxifene
The usual dose is one 60-mg tablet daily.
Precautions for Bone disorder drugs
Aldendronate
People with low levels of calcium in their blood should not take this medicine. It also
is not recommended for women on hormone replacement therapy or for anyone with kidney
problems. Before using alendronate, anyone who has digestive or swallowing problems should
make sure that his or her physician knows about the condition.
Calcitonin
Calcitonin nasal spray may cause irritation or small sores in the nose. Check with a
physician if this becomes very uncomfortable or if there is bleeding from the nose.
The injectable form of calcitonin has caused serious allergic reactions in a few
people. The nasal spray is not known to cause such reactions, but the possibility exists.
Before starting treatment with calcitonin, the physician who prescribes the drug may order
an allergy test to make sure there will not be a problem.
Raloxifene
A rare, but serious side effect of raloxifene is an increased risk of blood clots that
form in the veins and may break away and travel to the lungs. This is about as likely in
women who take raloxifene as it is in women who take estrogen. Because of this possible
problem, women with a history of blood clots in their veins should not take raloxifene.
Women who have had breast cancer or cancer of the uterus should check with their
physicians about whether they can safely use raloxifene.
General precautions for bone disorder drugs
To keep bones strong, the body needs calcium and vitamin D. Dairy products and fish
such as salmon, sardines and tuna are good sources of both calcium and vitamin D. People
who are taking bone disorder drugs for osteoporosis and who do not get enough of these
nutrients in their diets should check with their physicians about taking supplements.
Other important bone-saving steps are avoiding smoking and alcohol and getting enough of
the kind of exercise that puts weight on the bones (such as walking or lifting weights).
People who are taking these drugs because they have too much calcium in their blood may
need to limit the amount of calcium in their diets. Too much calcium may prevent
the medicine from working properly. Discuss the proper diet with the physician who
prescribed the drug, and do not make any diet changes without the physician's approval.
Anyone who has had unusual reactions to bone disorder drugs in the past should let his
or her physician know before taking the drugs again. The physician also should be told
about any allergies to foods, dyes, preservatives, or other substances.
Women who are pregnant or who may become pregnant and women who are breastfeeding
should check with their physicians before using this alendronate or calcitonin. Raloxifene
should not be used by women who are pregnant or who may become pregnant. In laboratory
studies of rats, raloxifene caused birth defects.
Side effects of Bone disorder drugs
Aldendronate
Common side effects include constipation, diarrhea, indigestion, nausea, pain in the
abdomen, and pain in the muscles and bones. These problems usually go away as the body
adjusts to the medicine and do not need medical attention unless they continue or they
interfere with normal activities.
Calcitonin
The most common side effects of calcitonin nasal spray are nose problems, such as
dryness, redness, itching, sores, bleeding and general discomfort. These problems should
go away as the body adjusts to the medicine, but if they do not or if they are very
uncomfortable, check with a physician. Other side effects that should be brought to a
physician's attention include headache, back pain and joint pain.
Injectable calcitonin may cause minor side effects such as nausea or vomiting;
diarrhea; stomach pain; loss of appetite; flushing of the face, ears, hands or feet; and
discomfort or redness at the place on the body where it is injected. Medical attention is
not necessary unless these problems persist or cause unusual discomfort.
Anyone who has a skin rash or hives after taking injectable calcitonin should check
with a physician as soon as possible.
Raloxifene
Common side effects include hot flashes, leg cramps, nausea and vomiting. Women who
have these problems while taking raloxifene should check with their physicians.
Interactions
Aldendronate
Taking aspirin with alendronate may increase the chance of upset stomach, especially if
the dose of alendronate is more than 10 mg per day. If an analgesic is necessary, switch
to another drug, such as acetaminophen (Tylenol) or use buffered aspirin. Ask a physician
or pharmacist for the correct medication to use.
Some calcium supplements, antacids and other medicines keep the body from absorbing
alendronate. To prevent this problem, do not take any other medicine within 30 minutes of
taking alendronate.
Calcitonin
Calcitonin may keep certain other drugs for Paget's disease, such as etidronate
(Didronel), from working as they should.
Raloxifene
Raloxifene may affect blood clotting. Patients who are taking other drugs that affect
blood clotting, such as warfarin (Coumadin), should check with their physicians before
using raloxifene. |
