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HealthInfo Canterbury

Osteoporosis treatments

Not everyone with osteoporosis will need to take medications. In some people, lifestyle changes and supplements may be enough. Activity, particularly weight-bearing exercise can help to make your bones stronger. Your doctor will advise you on available medications and what may be suitable for you.

On this page

Calcium

Vitamin D

Bisphosphonates

Zoledronate infusion

Other treatments

Monitoring

Calcium

Make sure you get enough calcium in your diet. For example, eat plenty of low-fat milk and milk products, calcium-enriched soy milk, some leafy green vegetables such as kale and Chinese cabbage, and canned fish with soft edible bones (like sardines and salmon).

If you can't or don't eat these kinds of foods, ask your doctor about calcium supplements. Recently, there has been publicity about whether calcium supplements increase the risk of heart attacks. Doctors are still not sure, but your GP can talk to you about what is best for you.

Vitamin D

You need to have plenty of vitamin D. Direct sunlight on your skin is the best way to get vitamin D, but it can be hard to balance this with the risk of skin cancer, and with the fact there may not be enough sunshine in winter to fulfil this requirement. In fact, in Christchurch, between July and August, you would need approximately 40 to 90 minutes in the sun every day to get enough vitamin D.

People with darker skin may need more time in the sun to get enough vitamin D, or instead may need to take a supplement.

Other ways to get vitamin D include eating foods containing vitamin D, such as oily fish, eggs, and vitamin D enriched-foods such as margarine, milk, and yoghurt. How to get your daily calcium has information about which foods contain vitamin D. You can also take a vitamin D supplement.

The Ministry of Health does not recommend using sunbeds to increase vitamin D levels, because of the risk of melanoma.

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Bisphosphonates

Bisphosphonates are a special group of medicines that can help to increase your bone density, reduce fractures, and bone pain, if present.

Bisphosphonates are often taken as tablets, which you take alongside supplements of vitamin D and calcium. There are several brands available, some of which are subsidised, which means you won't pay the full price for them. All medications for osteoporosis have quite specific guidelines about how and when they should be taken, which your doctor and pharmacist will explain to you. It's very important that you follow these instructions, and that you continue to take your prescribed supplements.

Medication information from:

Zoledronate infusion

Zoledronate, which is sometimes called zoledronic acid, is a powerful bisphosphonate that can be an effective treatment for osteoporosis. It is available as a once-yearly or 18-monthly intravenous infusion. This can be done at many general practices, or your doctor can refer you to another general practice to have the procedure. Some private facilities offer the procedure, and a small number are done in the public hospital if strict criteria are meet. In general practice, there is usually a charge for this but your general practice may be able to apply for funding to help with the cost.

If your doctor thinks you will benefit from zoledronate infusion, they will arrange for the necessary tests and approvals and give you more information.

Medication information from:

Other treatments

For some women HRT helps to treat osteoporosis. This may be appropriate for you if you are under 60 years and have menopausal symptoms.

Other treatments that are publicly funded and sometimes used are raloxifene (Evista) and teriparatide (Forteo).

Monitoring

The exact length of time you should stay on medication is unclear. Your doctor will monitor your treatment with these medications and help decide what monitoring may me helpful. There is a bone clinic at Burwood Hospital for men and women with complex bone problems and you may be referred there.

On the next page: Reducing my risk of osteoporosis

Information provided by the Canterbury DHB. Endorsed by HealthInfo clinical advisers. Updated June 2016.

Page reference: 41726

Review key: HIOSP-24517