Medicines that May Cause Bone Loss

Some medicines can be harmful to your bones, even if you need to take them for another condition. Bone loss is usually greater if you take the medication in high doses or for a long time.

It’s important to talk with your healthcare provider about the risks and benefits of any medicines you take and about how they may affect your bones, but do not stop any treatment or change the dose of your medicines unless your healthcare provider says it’s safe to do so. If you need to take a medicine that causes bone loss, work with your healthcare provider to determine the lowest possible dose you can take to control your symptoms.

The following medicines may cause bone loss:

  • Aluminum-containing antacids
  • Antiseizure medicines (only some) such as Dilantin® or Phenobarbital
  • Aromatase inhibitors such as Arimidex®, Aromasin® and Femara®
  • Cancer chemotherapeutic drugs
  • Cyclosporine A and FK506 (Tacrolimus)
  • Gonadotropin releasing hormone (GnRH) such as Lupron® and Zoladex®
  • Heparin
  • Lithium
  • Medroxyprogesterone acetate for contraception (Depo-Provera®)
  • Methotrexate
  • Proton pump inhibitors (PPIs) such as Nexium®, Prevacid® and Prilosec® 
  • Selective serotonin reuptake inhibitors (SSRIs) such as Lexapro®, Prozac® and Zoloft®
  • Steroids (glucocorticoids) such as cortisone and prednisone
  • Tamoxifen® (premenopausal use)
  • Thiazolidinediones such as Actos® and Avandia®
  • Thyroid hormones in excess

Note: This list may not include all medicines that may cause bone loss.

Osteoporosis and Steroid Medicines

While steroid medicines can be lifesaving treatments for some conditions, they can also cause bone loss and osteoporosis. These medicines are often referred to as steroids, glucocorticoids or corticosteroids. They should not be confused with anabolic steroids, which are male hormones that some athletes use to build muscle.

Steroids are much like certain hormones made by your own body. Healthcare providers prescribe them for many conditions, including rheumatoid arthritis (but not osteoarthritis), asthma, Crohn’s disease, lupus and allergies. They are often prescribed to relieve inflammation. They are also used along with other medicines to treat cancer and autoimmune conditions and to support organ transplants. Common steroid medicines are cortisone, dexamethasone (Decadron®), methylprednisolone (Medrol®) and prednisone. Intravenous forms include methylprednisolone sodium succinate (Solu-Medrol®).

Taking steroid medicines as pills in a dose of 5 mg or more for three or more months can increase the chance of bone loss and developing osteoporosis. Talk with your healthcare provider about taking the lowest dose for the shortest period of time for your condition. If you need to take steroid medicines for longer than this, you should take steps to prevent bone loss. While taking steroids, it is especially important to get enough calcium and vitamin D. It’s also important to exercise and not smoke. You may also want to ask your healthcare provider if you need a bone density test.

Related

Low Bone Density

Low bone density is when your bone density is lower than normal, but not low enough to be considered osteoporosis. People with low bone density are more likely to break a bone and may have a greater chance of getting osteoporosis because they have less bone to lose.

Managing Your Pain

Recovering from broken bones can be a long and painful process for some people. If you have ongoing pain, talk to your healthcare provider about what you can do to control your pain. 

Treatment with Osteoporosis Medication

There are many things to think about when choosing the right osteoporosis medicine. You and your healthcare provider may want to look at several things.