Drugs for bone disorders
These drugs used to treat disorders affecting bone formation, replacement, and repair.
The body constantly breaks down and rebuilds bone. Disorders can develop if the balance between breakdown and renewal is upset. Drugs that affect bone growth are used to treat disorders in which either too much bone is broken down or bone grows abnormally. For example, in osteoporosis, bone is broken down faster than it is replaced; in Paget's disease of the bone, there is abnormal bone formation.
|Bisphosphonates: Alendronate, Etidronate||Calcium and Vitamin D: Calcitriol, Calcium carbonate, Ergocalciferol, Vitamin D|
|Oestrogen and compounds with oestrogen-like effects: Conjugated oestrogens, Estradiol, Raloxifene, Tibolone||Calcitonin:|
What are the types of drugs for bone disorders?
Drugs used to treat bone disorders include bisphosphonates, calcium and vitamin D, oestrogens and compounds with oestrogen-like effects, and the hormone calcitonin.
These drugs have replaced hormone replacement therapy as the first-line treatment for osteoporosis; they are also used to treat Paget's disease. The drugs work by reducing abnormally high rates of bone breakdown and renewal and are usually taken orally. Side effects may include nausea, diarrhoea, and indigestion.
Calcium and vitamin D
These substances are essential for maintaining healthy bone. Supplements may be used to treat bone disorders. Postmenopausal women require a daily calcium intake of 1,200-1,500 mg, much of which can be obtained in the diet. Calcium supplements may cause constipation.
Vitamin D helps the body to absorb calcium from food. Deficiency is rare but can cause rickets in children and osteomalacia in adults (see Osteomalacia and rickets). Taken at the recommended dose, vitamin D supplements usually cause no side effects.
Oestrogen drugs and compounds with oestrogen-like effects
The sex hormone oestrogen and compounds with oestrogen-like effects slow the breakdown of bone and may be used to prevent osteoporosis or to slow its progress. However, oestrogens, either alone or with progestogens, and tibolone are no longer usually recommended as the first-line treatment for the prevention or treatment of osteoporosis (see Hormone replacement therapy).
Raloxifene is used for the prevention and treatment of osteoporosis after the menopause. Side effects include hot flushes, leg cramps, rashes, and breast discomfort. There is also a risk of thromboembolism (see Thrombosis and embolism).
This drug slows the rate of bone breakdown and renewal. It may be used to treat Paget's disease and to reduce the risk of osteoporotic fractures in some postmenopausal women. Calcitonin may be given as a nasal spray or by self-injection several times a week. Side effects of calcitonin may include irritation at the injection site, nausea, and hot flushes.
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