Table 1. Osteoporosis therapies, mechanisms, benefits ad risks |
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| Medication | Primary Mechanism |
Benefits | Risks |
| Conventional ERT | Inhibits bone resorption | Improves vasomotor symptoms of menopause | Increased risk of estrogen-related cancer, venous thrombosis, hypertension, gallbladder disease. |
| Calcitonin | Inhibits bone resorption | No estrogenic effect; analgesic effect on bone pain |
Secondary hyperparathyroidism;
anti-CT antibody production Injectable: nausea, vomiting, vertigo. Intranasal: rhinitis, nasal irritation |
| Bisphosphonates | Inhibits bone resorption | No estrogenic effect | Gastric erosion, thyroid
adenoma (rats); Safety of Tx. > 4 years not known |
| Sodium Fluoride | Stimulates osteoblasts (bone formation) | Increases bone mineral density for up to 5 years | Abnormal bone crystallinity; no decrease in hip fracture rate; decrease in cortical bone in favor of trabecular bone; acute GI nausea, vomiting, and hemorrhage |
| Selective Estrogen Receptor Modulators (Raloxifene) | Inhibits bone resorption | Estrogen effect on bone and lipids; not on breast or uterus | Increased risk of venous thrombosis, pulmonary embolism; fatal liver toxicity; ovarian tumors and hepatic cancer (animals) |
| Ipriflavone | Inhibits osteoclast and enhances osteoblast activity | No estrogen effect; fewer side effects; analgesic effect on bone pain | GI upset |
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