Osteoporosis Medication: What You Need to Know

If you’ve been told you have osteoporosis, the first question is usually “what can I take to stop my bones from getting weaker?” The good news is there are several medicines designed to keep bone loss slow or even help you build a bit of bone back. Below we break down the most common options, how they work, and what to watch for.

Common Drug Classes

Bisphosphonates are the most prescribed. Drugs like alendronate (Fosamax) and risedronate (Actonel) stick to bone surface and tell the cells that break down bone (osteoclasts) to slow down. You usually take them once a week or once a month as a pill. Some people take a pill every day for a short period. Common side effects are mild stomach upset, heartburn, or rare jaw problems. Taking the pill with a full glass of water and staying upright for 30 minutes helps avoid stomach issues.

Denosumab (Prolia) is a shot given under the skin every six months. It works by blocking a signal that tells osteoclasts to become active. Many patients like the twice‑yearly schedule, but you need a doctor’s appointment for each injection. Possible side effects include skin reactions at the injection site and a small increase in infection risk.

Selective Estrogen Receptor Modulators (SERMs) such as raloxifene (Evista) act like estrogen on bone but not on breast or uterus. They help keep bone density up and also lower the risk of breast cancer. Women who can’t take estrogen often use SERMs. Watch for hot flashes and an increased risk of blood clots.

Parathyroid Hormone Analogs like teriparatide (Forteo) actually stimulate bone formation. They are given as a daily injection for up to two years. Because they are more expensive, doctors reserve them for people with severe bone loss or fractures that haven’t responded to other meds. Common complaints are nausea and dizziness.

Calcitonin (Miacalcin) is a nasal spray or injection that slows bone breakdown. It’s less powerful than other options, so it’s usually a backup when other drugs can’t be used. Side effects are mostly nasal irritation or mild stomach upset.

How to Choose and Use Safely

First, talk with your doctor about your bone density score, overall health, and any other medicines you’re taking. Some drugs interact with steroids, certain heart meds, or can’t be used if you have kidney problems. Your doctor will pick the class that fits your situation best.

Follow dosing instructions exactly. For pills, take them with a full glass of water on an empty stomach, and stay upright for at least half an hour. Missing a dose or taking it with food can reduce how well the drug works.

Keep track of side effects. Mild stomach pain after a bisphosphonate pill is common, but severe jaw pain, unusual swelling, or persistent fever needs a doctor’s call right away. For the injection drugs, watch the injection site and report any signs of infection.

Don’t stop medication on your own. Stopping bisphosphonates suddenly can cause a rebound increase in bone loss. If you’re thinking about taking a break, discuss a “drug holiday” plan with your doctor.

Combine medication with lifestyle steps. Make sure you get enough calcium (about 1,000 mg daily) and vitamin D (800‑1,000 IU daily). Weight‑bearing exercises like walking, light jogging, or resistance bands help keep bone strong. Avoid smoking and limit alcohol, as both hurt bone health.

Finally, schedule regular bone density tests. Your doctor usually checks every 1‑2 years to see if the medication is working. If scores improve, you may stay on the same drug; if not, the doctor might switch you to a different class.

Understanding the options and how to use them makes osteoporosis a manageable condition rather than a scary diagnosis. With the right medicine, proper dosing, and healthy habits, you can protect your bones and stay active for years to come.