Osteoporosis Treatment: Medication - Doctor | Singapore General Hospital

Osteoporosis - Treatments

A successful action plan to prevent or treat osteoporosis involves several elements that contribute to overall bone health. These elements include:

Adequate intake of calcium and vitamin D
Adequate low impact weight-bearing activities e.g. jogging, walking, water aerobics, light gardening, treadmill walking for 2-3 times a week at least and to accumulate 30 minutes each time.
Adequate protein intake may have a protective effect on your bone structure
Avoid smoking
Avoid excessive intake of alcohol
Avoid very high fibre diets
Avoid high sodium intake
Avoid high caffeine intake

Calcium in your diet

Calcium helps in the production of strong bones. Vitamin D helps calcium to be easily absorbed into the bones. Therefore, it is important to know which kinds of food are rich in calcium and Vitamin D. The recommended daily intake of dietary calcium is 1000mg to 1200mg, and for Vitamin D is 600(IU) to 800(IU). The best way to obtain enough Vitamin D is to have at least 30 minutes of sunshine a day. If sun exposure is not advisable because of medical reasons, Vitamin D can also be obtained in foods e.g. egg yolk, cod liver oil, oily fish such as herrings and sardines.

Calcium supplement

If you are not getting enough calcium in your diet, you may need a calcium supplement. When you look for a calcium supplement, be sure the number of milligrams on the label refers to the amount of elemental calcium, and not to the strength of each tablet. The recommended daily amount of calcium is given in terms of elemental calcium. Elemental calcium is the actual amount of calcium that is available for your body to absorb.

Tips on getting the most out of calcium supplements

Read package labels carefully. Pay attention to the amount of elemental calcium per serving size. For example, 800mg of elemental calcium is available in each serving size and each serving size may consist of 4 tablets.
Take calcium supplements with meals as this helps with absorption.
Calcium supplements may cause gas, bloating and constipation in some people. To avoid such side effects, drink plenty of fluids, exercise and eat plenty of vegetables and fruits.
Please check with your doctor for recommendations of calcium supplements when in doubt.

Drug treatments for Osteoporosis

Group	Method of administration	How It Works
Bisphosphonates	Oral (eg. Alendronate, Risedronate, Ibandronic)	Oral bisphosphonates are the most commonly prescribed medications used for the treatment of osteoporosis. Patients have to follow specific instructions on how to take their medication so as to maximize effectiveness and minimize side effects.
	Intravenous infusion (Zoledronic Acid)	This is an intravenous alternative for patients who are unable to take oral bisphosphonates.
Selective Oestrogen Receptor Modulator	Oral (Raloxifene)	This acts like oestrogen to prevent bone loss by decreasing bone resorption and increasing bone mineral density.
Parathyroid Hormone Treatment	Subcutaneous injection (Teriparatide)	This is given by subcutaneous injection daily and can increase bone mineral density, bone mass, and bone strength, in patients who have failed bisphosphonates.
Monoclonal Antibody	Subcutaneous injection (Denosumab)	This is a monoclonal antibody which reduces bone resorption and increases bone mass. It is only administered subcutaneously twice a year.