Patients at increased risk of aspiration should not receive alendronate solutionġ0 mg per day or 70 mg per week, tablet or solutionĪlendronate/cholecalciferol (Fosamax Plus D)ħ0 mg plus 2,800 IU per week 70 mg plus 5,600 IU per weekĥ mg per day 35 mg per week 75 mg in two consecutive days per month 150 mg per month Hypersensitivity to any component of this product Inability to stand or sit upright for at least 30 minutes Medications for preventing and treating postmenopausal osteoporosis are listed in Tables 1 and 2.īisphosphonates (oral unless otherwise specified)ĥ mg per day or 35 mg per week, tablet or solution Hormone therapy (i.e., estrogen or combined estrogen/progestogen) positively affects bone health it is approved for use in women with an increased risk of osteoporosis and fracture. Whether there should be a limit to the duration of bisphosphonate therapy is unknown however, there appears to be a trend toward interrupting therapy after five to 10 years. Typically, combination therapy is not recommended. Calcitonin has weaker data compared with other options therefore, it should be used only in women with less serious osteoporosis who cannot tolerate other treatments. Teriparatide (Forteo) is typically only used in women with severe osteoporosis or who have had fractures. Raloxifene (Evista) can be a good initial treatment in younger postmenopausal women, and denosumab is an option for women with a high risk of fracture.
This manuscript reviews relevant data related to calcium and vitamin D use for patients at risk for fracture due to bone loss.īone calcium hip fracture osteopenia osteoporosis vitamin D.First-line therapy usually consists of bisphosphonates selection should be based on patient preference. A 'bricks and mortar' analogy is often helpful when counseling patients and this analogy will be explained. When pharmacologic therapy is advised, continued use of calcium and vitamin D is recommended for optimal fracture risk reduction.
A recently released algorithm (FRAX) estimating absolute fracture risk allows the health care provider to decide when pharmacologic therapy is warranted in addition to calcium and vitamin D. Compliance to calcium and vitamin D therapy is paramount for effective prevention of osteoporotic fractures. Dietary intake or supplementation with calcium and vitamin D will be reviewed, including recent recommendations for increased vitamin D intake. In addition, the optimal standard of care for osteoporosis should encompass adequate calcium and vitamin D intake.
Calcium and vitamin D utilization in the optimization of bone health is often overlooked by patients and health care providers. Osteoporosis poses a significant public health issue, causing significant morbidity and mortality.
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