Risk Factors for Osteoporosis: Medications

There are several medications that may increase the risk for osteoporosis by either reducing peak bone mass (when the medication is taken during youth or young adulthood) or increasing bone loss. Do not stop or change the way you take any medication without medical advice.

  • A checklist of the medications known to be associated with an increased risk for osteoporosis follows. This is a list of those medications commonly associated with increased risk for osteoporosis. However, it is important to be aware that research is ongoing and there may be other medications found to contribute to osteoporosis.
  • Although the medications listed below may increase your risk for bone loss and/or osteoporosis, taking these medications does not mean that you have or will get the disease. However, the fact that you need one of these medications should increase your awareness of the potential for bone loss and should motivate you to discuss your concerns with your healthcare provider.

Medication Risk Assessment

Are you taking or have you taken any of the following medications?

  • Steroids (such as prednisone or cortisone) used for more than 3 months to treat asthma, arthritis, inflammatory bowel disease or other diseases/conditions.
  • Gonadotropin-releasing hormone agonists (such as lupron and zoladex) used to treat endometriosis or prostate cancer.
  • Thyroid medications, taken in high dosages, or lack of routine blood tests for TSH-level monitoring.
  • Phenytoin (brand name: Dilantin),valproic acid (brand name: Depakote), and some of the other medications used to treat seizure disorder or depression.
  • Some types of chemotherapy.
  • Immunosuppressants (such as methotrexate or cyclosporine).
  • Blood thinning agents when prescribed for long-term use (such as coumadin or heparin).

If you take any of the above medications, speak to your healthcare provider about how to protect your bones. Do not stop or change the way you take any medication without medical advice.

There are some very simple steps to take to help protect your bones:

Eat a variety of healthy (nutrient-rich) foods. Make half your plate vegetables and fruit, add lean protein, include whole grains, select heart-healthy fats, and remember to include a calcium-rich food or drink at each meal. For more information about healthy food choices, go to www.choosemyplate.gov

Reach and maintain a healthy weight. Eat the amount of calories and protein you need. The amount that you need will depend on your height, weight, age, and medical condition.

Get the calcium you need. Consume 1000 to 1200 milligrams (mg) of calcium each day. It is best to get calcium from the foods you eat. Foods rich in calcium such as low fat dairy foods (milk, yogurt, cheese), dark green leafy vegetables (bok choy, broccoli, collard greens, kale, mustard greens, and turnip greens), canned fish (sardines, salmon) eaten with bones, or calcium-fortified (with calcium added) foods. Try to eat a calcium rich food at each meal. Add calcium supplements (pills) only when you cannot get the calcium you need from food alone.

Get the recommended amount of vitamin D. There are only a few good natural sources of vitamin D including fatty fish such as catfish, eel, mackerel, salmon, sardines, and tuna. Small amounts of vitamin D are added to all milk and some types of soy milk, rice milk, almond milk, yogurt, cheese, juice, and nutrition bars. Adults 50 years of age and above should consume 800-1000 IU or 20-25mcg daily. Your healthcare provider may recommend more vitamin D than above stated amounts based on your individual needs.

Be physically active. Your bones get stronger and denser when you make them work. Walking, climbing stairs, and dancing are impact (or weight-bearing) exercises that strengthen your bones by moving your body against gravity when you are upright. Resistance exercises such as lifting weights or using exercise bands strengthens your bones and your muscles too! Tai Chi is an example of physical activity that improves posture and balance to help decrease your risk for falls and fractures. Exercise can be easy; try 10 minutes at a time, adding the minutes up to reach your goal.

Don’t smoke. If you do, STOP. Call 1-800-NYQUITS for information about how to quit.

Limit alcohol. Before drinking alcohol, it is important to speak to your healthcare provider about possible interactions with your medication or your medical condition. Too much alcohol can be bad for your bones and your overall health.

Take action to prevent falls. Most broken bones occur as a result of a fall that can be prevented. Some actions to prevent falls at home include using night lights, removing or securing scatter rugs, and getting rid of clutter.

After careful review of your medical history and risk factors for osteoporosis, your healthcare provider may recommend a bone mineral density (BMD) test when appropriate. If osteoporosis is diagnosed, it is necessary to make bone healthy lifestyle choices. However, lifestyle modifications alone are often not enough for postmenopausal women or men taking long-term medications that cause bone loss or for individuals diagnosed with osteoporosis. Your healthcare provider may tell you that you need an osteoporosis medication to help stop further bone loss and to reduce your risk for broken bones. It is rare for healthcare providers to prescribe osteoporosis medications for young people under age 50.