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    If you have been diagnosed with osteoporosis by your doctor it may be required that you take osteoporosis medications in addition to carrying out lifestyle changes in order to combat your condition.

    Many people are unable to tolerate oral bisphosphonates such as Fosamax and Actonel, which have many known side effects. This type of medication should not be taken by people with hypocalcemia, renal insufficiency, esophageal irritation, or have undergone recent dental surgery (which has been closely linked with the risk of jaw necrosis). For these people other osteoporosis treatment options such as Evista, Forteo, Miacalcin, Protelos, Prolia or estrogen treatment are worthy of consideration.

    Evista - Selected Estrogen Receptor Modulator Raloxifene

    The selective estrogen receptor molecule raloxifene has been shown to delay the decomposition of bone by blocking cytokine signaling at the osteoclast. Raloxifene is manufactured as the drug Evista by Eli Lilly. Interestingly raloxifene acts as both an agonist and an antagonist to cytokine signaling depending on the location within the body, in the breast and uterus it is an antagonist, but at the bone it acts as an agonist with bone estrogen receptors.

    Taking Evista - Raloxifene

    Raloxifene taken as the drug Evista is usually taken at a dose of 60 mg per day to treat postmenopausal osteoporosis. This dose has been demonstrated to both reduce the risk of osteoporosis fractures and increase bone mineral density. It is important not to take Evista if you have venous thromboembolism. Some of the side effects of taking Evista include leg cramps and hot flushes.

    Benefits of Taking Evista

    It has been shown that taking Evista is able to reduce osteoporosis vertebral fractures by as much as 40% one year after the start of treatment. With regards to spinal fractures, these may be reduced by 55% in people with no history of spinal fractures, and 30% in those with a history of spinal fractures (in people who took Evista for a three year period). Although Evista has been shown to be beneficial to vertebral fractures in clinical trials, there was no significant correlation between taking the raloxifene drug and a decrease in the risk of getting non-vertebral fractures.

    The use of Calcitonin (Miacalcin) in Osteoporosis Treatment

    Many people are unable to tolerate osteoporosis treatments such as bisphosphonates, fortunately there are other pharmaceuticals such as Evista and Miacalcin that may be used in the prevention of osteoporosis.

    How Does Miacalcin Work?

    Salmon calcitonin is a polypeptide hormone that is used in the fight against osteoporosis as it is able to inhibit osteoclasts that are involved in bone remodeling. Calcitonin is manufactured by Novartis, and marketed as the drug Miacalcin. The drug can be taken by two daily methods: either as a 200 IU intranasal spray, or as a subcutaneous injection. Although Miacalcin does have approval for use in osteoporosis treatment by the FDA, the approval is only for women who are five or more years past their menopausal.

    Clinical Trials Reveal that Calcitonin Reduces Vertebral Fractures
    Clinical trials carried out on Calcitonin showed that when the drug was taken as a nasal spray at a dose of 200 IU, that over a 5-year period the risk of getting a vertebral osteoporosis fracture was reduced by 33%. Additionally, it was found that a reduction in the pain associated with compressional fractures occurred. However, the trial also showed that there was no reduction in the risk of non-vertebral fractures, nor an increase in bone mineral density.

    Miacalcin Side Effects

    There are a few side effects associated with the use of Miacalcin; these vary depending upon how the Miacalcin is taken.

    1. Side effects of Miacalcin nasal spray: these include itching, dryness and epistaxis
    2. Side effects of Miacalcin injections: Rashes, flushes, local reactions.

    Forteo Osteoporosis Medication - Human Parathyroid Hormone Teriparatide Treatment

    The human parathyroid hormone teriparatide is an anabolic steroid that is able to stimulate the bone remodeling system into building bone. Teriparatide is manufactured by Eli Lily under the brand name of Forteo. The use of Forteo has been approved by the FDA for women who have a bone mineral density T-score of less than -3.5, and are therefore considered to be at great risk of getting an osteoporotic fracture.

    Taking Forteo

    Forteo comes in a cartridge that delivers a dosage of 20mg per day via a multidose pen for a four week period. The Forteo injection (human parathyroid hormone teriparatide) is (through the pen) into either the thigh or abdomen subcutaneous tissue.

    How does Forteo work?

    Forteo is an anabolic steroid that is able to regulate metabolism of the bone, the absorption of calcium in the intestines and the reabsorption of calcium and phosphate in the renal tube. The steroid acts to stimulate osteoblasts into creating new bone in trabecular and cortical surfaces. After the Forteo pen injects the drug, in either the thigh or abdomen, the calcium levels in the serum increase after about 2 hours and reach a maximum after 5 hours. After about 24 hours the levels of calcium in the serum will return to normal levels.

    Effectiveness of Forteo for Osteoporosis

    The use of the human parathyroid hormone teriparatide (Forteo) has very effective results; it has been shown in clinical trials to reduce the risk of spinal fractures by as much as 65% in the one and half years after treatment, and to reduce non vertebral fractures by 53%.

    Forteo Side Effects

    Unfortunately, there is little safety information available for Forteo, therefore the use of the human parathyroid hormone teriparatide as an osteoporosis treatment is limited to two years.

    There are many Forteo side effects which occur at quite a high percentage: these include nausea, dizziness, leg cramps, post injection hypercalcemia and arthralgias. It is recommended that people, who are being treated by radiation therapy, have skeletal malignancies, or Paget's disease, do not take Forteo.

    References

    Bazaldua and Bruder (2004). Teriparatide (Forteo) for osteoporosis. Fam Physician. :1983 to1984
    Chesnut et al (2000). A randomized trial of spray salmon calcitonin in postmenopausal women with established osteoporosis: the prevent recurrence of osteoporotic fractures study: PROOF Study Group. J Med. :267–276
    Ettinger et al (1999). Reduction of vertebral risk in postmenopausal women with osteoporosis treated with raloxifene: Results from a 3-year randomized clinical trial: Multiple Outcomes of Raloxifene Evaluation (MORE) Investigators 637 to 645
    Ettinger et al (2004). Differential effects of teriparatide on BMD after treatment with raloxifene or alendronate. J Bone Miner Res. :745 to 751
    Mayes (2007) Review of post menopausal osteoporosis pharmacology. Nutr. Clin. Prac. 22:3: 276 to 285
    Mauck and Clarke (2006). Diagnosis, screening, prevention, and of osteoporosis. Clin Proc. 662–672