Antiresorptives are the most common and best known Osteoporosis medications. Antiresorptives slow down the Osteoclasts. They target the Osteoclasts and prevent them from eating away (resorbing) the bone. They come in several varieties.
We can reassert hormonal control of the Osteoclasts which eat away bone, and bring them back into balance with the Osteoblasts which make new bone. Modern Hormone Replacement Therapy for women is much safer now than it was. We also have Raloxifene (Evista) which can both control bone loss and prevent Invasive Breast Cancer in women. Men can be deficient in Testosterone and sometimes use Testosterone Replacement.
Anabolic medications speed up new bone formation to catch and outrun bone being eaten away. Anabolics stimulate the Osteoblasts to form additional new bone matrix. This is usually the best treatment for severe osteoporosis with multiple Fragility Fractures, extremely low DXA scores, or falling bone density on other medications.
Remember that none of these medications can work without enough Calcium and Vitamin D.
Determining the best medication for each individual requires a detailed evaluation of your medical history, full lab work, DXA score and trend, VFA, and your personal living situation. Most individuals require an office visit dealing solely with Osteoporosis to have enough time to get it right.
Jay Ginther, MD
2008 / Revised December 2010