- General Information
- See Your Pharmacist or Medical Professional
- Treatment Tips
- Treatment Options
- More Information
Osteoporosis, which means ‘porous bones’, is a condition where your bones become thinner or less dense, and more likely to break. Osteoporosis affects more than 50% of women and about 30% of men over the age of 60 years.
To build and maintain healthy bones your body needs calcium, other minerals and enough hormones, including oestrogen in women and testosterone in men. Vitamin D is also needed so you can absorb calcium from food and incorporate it into your bones.
Osteoporosis develops slowly over many years, often without any symptoms. The first sign that someone has osteoporosis can be when they have a fall, which causes a bone to break (fracture).
Fractures of the hip, spine and wrist are commonly seen in people with osteoporosis. These types of fractures can be serious and lead to chronic pain, problems with mobility and may mean people can no longer live independently.
Some people are more at risk of osteoporosis than others.
- being female
- being past menopause
- reaching menopause or having your ovaries removed before the age of 45
- being aged 50 years or older
- having a family history of osteoporosis
- being tall and thin
- having white (Caucasian) or Asian ancestry
- having a diet low in calcium and/or vitamin D
- weight disorders such as anorexia nervosa
- excessive alcohol intake
- having a sedentary lifestyle (not being active)
- not spending enough time outdoors in sunlight
- taking medicines such as steroids or anticonvulsants
See Your Pharmacist or Medical Professional
- your doctor or pharmacist can help you assess your risk for osteoporosis and may suggest you have a bone density scan (a type of X-ray)
- bone mineral density (BMD) is used to measure your osteoporosis risk. The lower your BMD, the higher your fracture risk
- also see your healthcare professional if you have:
- fractured a bone already; you may need medicines to reduce the risk of further fractures
- had frequent falls, as this increases your risk of fractures. Find out if there are ways of reducing your falls (see Treatment Tips below)
- a visual impairment or problems with your balance
There is no cure for osteoporosis, but medicines and lifestyle changes can help:
- make lifestyle changes as early as possible to avoid osteoporosis developing
- tai chi (a form of martial art) exercises have been shown to prevent falls
- stop smoking
- reduce your alcohol intake
- eat a healthy diet with plenty of calcium-containing foods, such as dairy products
- try to do 30 minutes of weight-bearing exercise, such as walking, every day
- have moderate exposure to sunlight (but avoid sunburn); sunlight encourages your body’s natural production of vitamin D
- reduce your risk of falling:
- ask for a review of your medicines; some can cause dizziness or drowsiness and make falls more likely
- have your eyesight checked; you need good sight to avoid tripping over or bumping into objects
- avoid high heels and wear non-slip soles
- a walking stick or frame can help your balance if you are unsteady when walking
- hip protectors will decrease the risk of fractures after falling
- an occupational therapist can assess for any household risks
- if you live alone, and are at risk of falling, consider having an alert system (preferably one that can be worn around your neck or wrist) that can be activated if you have fallen and cannot move
e.g. calcium carbonate (CAL-600 Tablets, Calci-Tab 600, Cal-Sup, Caltrate Tablets, CalSource Ca1000 (dispersible tablets)), calcium citrate (Citracal)
- calcium can slow bone loss but does not completely stop it
- the recommended intake of calcium is 1000 to 1500 mg daily
- some people, particularly the elderly, may need to take supplements if they are not getting enough calcium from their diet
- calcium supplements are available as tablets, chewable tablets and effervescent tablets, which can be dissolved in water
- calcium is best taken with meals because eating food produces more stomach acids which help to absorb it
- calcium can interfere with the absorption of some other medicines; check with your pharmacist
Vitamin D preparations
- most younger people obtain enough vitamin D from their diet and exposure to sunlight
- low vitamin D levels are common in elderly people
- vitamin D is usually included in multivitamin preparations; high doses of vitamin D can be harmful so do not take more than recommended
- higher doses of vitamin D may be needed by elderly people; colecalciferol supplements appear to reduce fracture rates significantly
- calcitriol is a potent form of vitamin D available only on prescription
- calcitriol can be prescribed for treatment of osteoporosis or to prevent osteoporosis due to long-term use of steroids (e.g. prednisone)
- it is important to follow your doctor’s dietary recommendations and not to take any other calcium supplements with calcitriol unless advised by your healthcare professional
- cod liver oil also contains vitamin D but should not be used at high doses due to its vitamin A content
e.g. colecalciferol 25 mcg (Blackmores Vitamin D3, Ostelin Vitamin D, OsteVit-D, YourHealth D3-1000 Vitamin D3)
e.g. colecalciferol 175 mcg (Ostelin 1-A-Week, OsteVit-D One-A-Week)
e.g. calcium carbonate + colecalciferol (Caltrate 600 mg with Vitamin D Tablets, Ostelin Vitamin D & Calcium, Ostevit D and Calcium), calcium citrate + colecaliferol (Citracal + D)
- these products contain calcium and vitamin D
e.g. alendronate (Alendro, Alendronate Sandoz, Fosamax), alendronate + colecalciferol (Dronalen Plus, Fosamax Plus Once Weekly), alendronate + calcium + colecalciferol (Dronalen Plus D-Cal); risedronate (Actonel EC, Actonel Once-A-Month), risedronate + calcium (Acris Combi), zoledronic acid (Aclasta infusion, Osteovan, Zoledasta)
- bisphosphonates slow the rate of bone loss and have been shown to reduce the risk of fractures in people with osteoporosis
- oral tablets should be taken on an empty stomach because food can reduce their absorption. Please check the product information or speak to your pharmacist before taking bisphosphonates as instructions on how to take each bisphosphonate correctly varies
- oral tablets can stick in the oesophagus (gullet) and cause irritation so they should be taken with plenty of water; stay upright for 30 minutes after taking to help the tablet go down
- zoledronic acid infusions need only be given once a year for osteoporosis
- it is important to tell your dentist you are using a bisphosphonate prior to any dental work
- tell your doctor if you experience any pains in your bones, joints or muscles or experience any new or worsening heartburn while using these medicines
e.g. denosumab (Prolia)
- denosumab is a protein (monoclonal antibody) that is used to improve bone mineral density and reduce fracture-risk
- denosumab works in the body for a long time and is given as an injection every six months
- it is important to tell your dentist you are using denosumab prior to any dental work
- you must ensure adequate intake of calcium and vitamin D
Hormone replacement therapy
e.g. estrogen-only products [for women who have had a hysterectomy] (Estrofem, Premarin, Progynova, Climara Patch, Estraderm Patch); combination products [for women with an intact uterus] (Angeliq 1/2, Femoston, Kliogest, Kliovance, Trisequens, Estalis Patch)
- hormone replacement therapy (HRT) is treatment for osteoporosis in women with low oestrogen levels, usually due to menopause
- HRT is available as a pill, patch, topical gel, pessary and cream
- HRT increases bone density and reduces fracture rates. However, HRT also increases the risks of blood clots, certain types of cancer, heart attacks and stroke, and is no longer widely recommended. It is sometimes used in post-menopausal women for whom bisphosphonates are not suitable, but the benefits of fracture reduction do not outweigh the risks associated with HRT use
- men with low testosterone levels may benefit from testosterone replacement
- raloxifene is used in the treatment of osteoporosis in post-menopausal women
- teriparatide can also be used to treat osteoporosis in men when there is a high risk of fractures and other medicines are unsuitable
For more information on supports for the home, visit the Independent Living Centres website at www.ilcaustralia.org
Availability of medicines
- GENERAL SALE available through pharmacies and possibly other retail outlets.
- PHARMACY ONLY available for sale through pharmacies only.
- PHARMACIST ONLY may only be sold by a pharmacist.
- PRESCRIPTION ONLY available only with a prescription from your doctor or other health professional.
Last Reviewed: 13/03/2020
1. Australian Medicines Handbook. Colecalciferol. 2020. Accessed 13/03/2020.
2. MIMS Australia. MIMSOnline. 2020. Accessed 13/03/2020.
3. Australian Medicines Handbook. Calcitriol. 2020. Accessed 13/03/2020.
4. Australian Medicines Handbook. Denosumab. 2020. Accessed 13/03/2020.
5. Australian Prescriber. Treating Osteoporosis. 2016; https://www.nps.org.au/australian-prescriber/articles/treating-osteoporosis-1. Accessed 13/03/2020.
6. Therapeutic Guidelines Ltd. eTG - Choice of drug therapy for osteoporosis. 2019. Accessed 13/03/2020.
7. Australian Medicines Handbook. HRT brands and forms. 2020. Accessed 13/03/2020.
8. Australian Medicines Handbook. Calcium. 2020. Accessed 13/03/2020.
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