Do any prescription drugs put me at greater risk for osteoporosis?
Some prescription and other drugs, if taken consistently for 6 months or more, can put you at risk for osteoporosis.
If you use any of the following drugs regularly, talk to you doctor or pharmacist:
Corticosteroids are generally used to treat some types of inflammation (swelling) and problems caused by an overactive immune system. Corticosteroid-type inhalers prescribed for asthma can also affect bone density in men and women. These drugs can decrease calcium absorption by the body and increase the movement of calcium out of bones. Some examples include:
- prednisone (Deltasone),
- prednisolone (Orasone),
- methylprednisolone (Medrol)
Anticonvulsants used to treat some types of seizure disorders can interfere with vitamin D metabolism, decrease calcium absorption by the body and increase the movement of calcium out of bones.
- phenytoin (Dilantin),
- sodium valproate
“Loop” diuretics (water pills) used to increase urine output can increase the amount of calcium lost in the urine.
- furosemide (Lasix),
- ethacrynic acid (Edecrin),
- bumetanide (Bumex).
Antacids containing aluminum can block the movement of calcium into bones and increase the movement of calcium out of bones.
- aluminum hydroxide gel products used chronically for stomach problems
Thyroid hormones are used in patients who do not produce enough of their own thyroid hormone. Using higher than necessary doses can cause bone loss, especially after menopause.
- levothyroxin (Synthroid)
Heparin is an injectable anticoagulant, (decreases blood clotting) occasionally used on a long-term basis during pregnancy for certain types of clotting problems.
Some other drugs associated with a higher risk for developing osteoporosis include:
- Phenothiazine derivatives such as chlorpromazine (Thorazine) used to treat schizophrenia and other types of mental illness.
- Gonadotrophin-releasing hormone (Gn-RH) used in some specific deficiency states
- Leuprolide (Lupron), nafarelin (Synarel), goserelin (Zoladex) most commonly used for endometriosis, non-cancerous uterine fibroid tumors, infertility, and prostate cancer
- Excessive doses of vitamins A and D
- Heavy intake of caffeine
- Heavy use of alcohol
- Medroxyprogesterone acetate (Depo-Provera) – used as a long-acting contraceptive
- Granulocyte Colony Stimulating Factor (G-M CSF) – used to treat certain types of low white blood cell and platelet disorders
The following drugs may contribute to the development of osteoporosis, but the evidence is based on animal studies or is otherwise inconclusive:
- Cyclosporin, an anti-rejection medication given to transplant patients
- Warfarin (Coumadin), an anticoagulant taken by mouth
- Methotrexate used to treat certain types of cancers, rheumatoid arthritis, and some skin problems
- Excessive doses of Vitamin C
- Extensive tetracycline use
- Cigarette smoking
Factors influencing the risk of osteoporosis following the use of these drugs include the dose (or amount) and the length of therapy.
The development of this topic was funded in part by the Ohio Department of Health.
For more information:
Go to the Osteoporosis health topic.