This is a continuation of last week’s article. I I discuss most treatment options here but I don’t have the space to discuss all treatments options so for more details info check www.whelehans.ie
Examples include Alendronate (Fosamax®, Fosavance®, Romax®), Risedronate (Actonel®, Ridate®) and Ibandronic Acid (Bonviva®).
Biphosphonates work by slowing down bone loss. They are taken once weekly but Bonviva® is once a month. Biphosphonates can reduce the frequency of fractures by 50%. Alendronate is generally considered first choice. The main side effects of biphosphonates are oesophageal irritation, abdominal pain, indigestion, regurgitation, diarrhoea, constipation, flatulence, muscle pain and headache. Biphosphonates should be taken with a good glass of water at least 30 minutes before breakfast on an empty stomach and the person must stand or sit upright for half an hour after taking (ie) not lie down. This is because if the patient lies down the tablet can get stuck in the oesophagus and cause irritation including ulcers.
Parathyroid hormone peptides (eg) Forsteo®.
This hormone helps to regulate calcium levels and the activity of cells involved in bone formation. It is a subcutaneous injection (into side of stomach usually), one injection is used daily. A trained nurse from Lilly will give training in your home initially for free. It reduces fractures by average of 41%. It is only used if you cannot tolerate other treatments, mainly because it is expensive however it is allowed on the medical card and drug payment scheme.
The selective oestrogen receptor modulator (eg) Raloxifene (Evista®).
This is a hormone that mimics the effect of oestrogen on the bones. One tablet is taken daily. It reduces risk of fractures by approx 47%. Unlike HRT, Evista® does not reduce menopausal symptoms like flushing and sweating. An advantage of Evista® is that it reduces the risk of oestrogen receptor type breast cancer so is a good option for those postmenopausal women prone to both osteoporosis and oestrogen receptor positive breast cancer. Evista® should be avoided in women prone to venous thromboembolism (clots in the veins) and side effects include hot flushes, leg cramps, minor fluid build up and slight flu like symptoms.
Hormone replacement therapy (HRT)
HRT relieves symptoms of the menopause by restoring hormones to a premenopausal level. HRT has also been shown to reduce osteoporosis, but it generally is not prescribed to treat or prevent osteoporosis. HRT should not be considered as the first line for postmenopausal osteoporosis in women over 50. HRT is of most benefit for the prevention of postmenopausal osteoporosis if started early in menopause and used up to 5 years. Your GP will discuss the risks and benefits with you.
Prolia® inhibits osteoclast formation so reduces the breakdown of bone. It is licensed for use in postmenopausal women at risk of osteoporosis or men who have bone loss due to prostate cancer. Prolia® is a six monthly subcutaneous injection which is given into the abdomen or thigh. It is mainly used for those unable to follow the more complicated dosage regime for other osteoporosis medication or cannot tolerate other osteoporosis medication. Side effects include constipation and urinary tract infections.
Disclaimer: Information given is suitable for the person above only; please ensure you consult with your healthcare professional before making any changes recommended
For comprehensive and free health advice and information call in to Whelehans, log on to www.whelehans.ie or dial 04493 34591 (Pearse St) or 04493 10266 (Clonmore). Find us on Facebook.