Osteoporosis medication: A guide for seniors

No bones about it: it’s never too early to lower your risk for osteoporosis.

About 54 million Americans are at risk for or suffer from osteoporosis.¹ It can affect both men and women, but experts estimate that about half of American women ages 50 or older may break a bone because of osteoporosis.¹

Read on to learn what osteoporosis is, who’s most at risk and what you can start doing—no matter your age or health level—to lower your risk or get treatment.

The facts about osteoporosis

Our bones are made of living tissue, which means they break down over time and are slowly replaced with new bone. When we’re young, we grow new bone tissue fast enough to keep up with the breakdown of old bone tissue. As we age, that growth slows, and our bones get weaker and wear down faster. This can lead to osteoporosis.²

Osteoporosis happens when old bone breaks down faster than new bone can grow. However, age isn’t the only thing that contributes to a person’s risk of developing osteoporosis. Other factors include:

• Sex: women are more likely than men to develop osteoporosis.
• Ethnicity: osteoporosis is more common in white and Asian women.
• Body size: people with smaller body frames are more likely to have osteoporosis. 
• Family history: if someone else in your family developed osteoporosis, your risk is higher, too.
• Hormone changes: less testosterone and estrogen, plus more thyroid hormones, can make someone lose bone density.
• Substance use: people who drink alcohol and use tobacco products are more likely to develop osteoporosis.

The biggest everyday danger from osteoporosis is falling. Falls can lead to fractures, which can cause a lot of pain and limit your mobility and independence.³ That’s why it’s important to talk to your doctor—and get treatment.

Medication to prevent and treat osteoporosis

While there’s no cure for osteoporosis, a doctor can prescribe drugs that may help reduce the risk of bone fractures and slow the breakdown of bone tissue.

One of the most common medications prescribed for osteoporosis is bisphosphonates (e.g. alendronate, ibandronate or risedronate). These medications work by slowing down bone removal or breakdown and can help make your bones stronger.⁵

Usually taken once a week or month as a pill, bisphosphonates may also be given as an IV infusion once or a few times a year. ⁴ Infusion works about as well as oral versions, and some people take them because it’s easier to schedule infusions than remembering to stick to their pill schedule.²

While all versions are good at reducing spine fractures, alendronate and risedronate are also recommended for reducing hip and other non-spine fractures.²

However, bisphosphonates aren’t for everyone. Some people, including those getting treatment for cancer,⁴ can’t take bisphosphonates because some cancer treatments can lead to more bone loss.³ For those patients, a doctor may prescribe zoledronic acid (Relcast), an infusion,² or injections of denosumab.⁴ For more severe cases, sclerostin inhibitors can help the body build new bone as well as slow down bone loss.³

Common side effects

In general, the side effects of bisphosphonates and other osteoporosis drugs aren’t much to worry about.

Bisphosphonates in pill form may cause stomach issues, such as nausea and acid reflux, because they aren’t easily absorbed by your digestive system. If you take these pills, try to avoid lying down, bending over or eating for 30 to 60 minutes after taking them. Bisphosphonates in IV infusion form don't usually cause upset stomach—but they may cause mild flu-like symptoms after the first treatment.²

Sometimes, people taking bisphosphonates experience more severe side effects. These include thighbone fractures and jawbone decay. However, these usually only happen in people who are also undergoing treatment for bone cancer or are on a high dose of bisphosphonates over a long period.⁴

Other ways to prevent osteoporosis

Eat healthy

Calcium is vital for bone health. Be sure to load up on calcium-rich foods like salmon, tofu, low-fat dairy, dark green leafy vegetables and broccoli. Vitamin D is also important because it helps the body absorb calcium. While vitamin D can be hard to get from food, you can find it in egg yolks, oily fish, fortified milk and cereals.³

If you’re having trouble getting enough calcium or vitamin D from your diet, supplements may help.

Get plenty of exercise

To build muscles and bone strength, try combining strength training with weights and balance exercises, as well as cardio like jogging or tennis. Also, sunlight is one of the best sources of vitamin D, so be sure to get outside exercise.¹ Most importantly, be sure to talk to your doctor or physical therapist before starting any new exercise.³

Get a bone density test

If you’re worried about your bone strength, you can get answers with a dual energy X-ray absorptiometry (DXA) test. This pain-free scan uses X-rays to measure the strength and density of your bones.³ If you have a low score from your DXA test, your prescriber may recommend certain medications.

To find out more, schedule an appointment with your doctor. If you don’t have a doctor, you can find care through CenterWell®.*

How CenterWell Pharmacy can help

You don’t have to let osteoporosis—and the risk of fractures that can lead to pain, disability and even death⁶—slow you down.

If your doctor gives you a prescription for a bisphosphonate or other medication, fill it with CenterWell Pharmacy®. We’ll ship it safely and securely to your door, saving you a trip to the pharmacy—and potentially money, too. And if you have any questions about your medication or managing your health, chat with us.

Sources:

1. “What You Can Do Now to Help Prevent Osteoporosis,” Johns Hopkins Medicine, last accessed Feb. 24, 2025.
2. “Osteoporosis drugs: Which one is right for you?,” Harvard Health Publishing, last accessed Feb. 24, 2025.
3. “Osteoporosis: Diagnosis, Treatment, and Steps to Take,” National Institute of Arthritis and Musculoskeletal and Skin Diseases, last accessed Feb. 24, 2025.
4. “Osteoporosis treatment: medications can help,” Mayo Clinic, last accessed Feb. 24, 2025.
5. “Bisphosphonates,” Cleveland Clinic, last accessed Feb. 24, 2025.
6. Kristie N Tu, et al, “Osteoporosis: A Review of Treatment Options,” Pharmacy and Therapeutics, accessed Feb. 20, 2025.

* CenterWell Primary Care® providers may not be available in all areas. Other primary care providers may be available in your insurance network.

Disclaimer: This material is provided for informational use only and should not be construed as medical advice or used in place of consulting a licensed medical professional. You should consult with your doctor to determine what is right for you.