Osteoporosis Treatments

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OSTEOPOROSIS TREATMENTS

Risk factors: age, gender, Asian or Caucasian
descent, petite and thin women, prior osteoporotic
fracture, femoral neck BMD, low BMI, rheumatoid
arthritis, family or personal history of hip fractures,
smoking, heavy alcohol intake, chronic gluco-
corticoid use, type 1 diabetes, hyperthyroidism,
hypogonadism, menopause at <45yrs of age, mal-
nutrition or malabsorption, chronic liver disease.

Prevention:

Recommended Calcium intake: 1–3yrs: 700mg;
4–8yrs: 1000mg; 9–18yrs: 1300mg; 19–50yrs:
1000mg; males 51–70yrs: 1000mg; females
51–70yrs, 71+yrs: 1200mg; pregnancy or nursing
mothers: 1000–1300mg

Recommended Vitamin D intake: >1yr: 600 
IU/day; 50+yrs: 800–1,000 IU/day. Usually met
through sunlight exposure.

HRT if bone loss due to estrogen deficiency at meno-
pause, initiate estrogen therapy at lowest effective
dose. Individualize and reevaluate periodically.
Intact uteri: prescribe progestin with estrogen.
Hysterectomy: may prescribe estrogen continuously.

Other: weight-bearing exercises, fall prevention,
smoking cessation, alcohol restriction, weight and
dietary management, preventative drug therapy

Generic Brand Strength Form Dose
BISPHOSPHONATES
alendronate Binosto 70mg effer-
vescent tabs for oral soln
Treatment: 70mg once weekly
Fosamax 5mg, 10mg, 35mg, 40mg, 70mg tab Treatment: 10mg once daily or
70mg once weekly
Prevention: 5mg once daily or
35mg once weekly
70mg/75mL oral soln
alendronate/
cholecalciferol
(Vit. D3)
Fosamax Plus D 70mg/2800 IU,
70mg/5600 IU
tab Treatment: 70mg/2800 IU or
70mg/5600 IU once weekly
ibandronate Boniva 150mg tab Prevention and Treatment:
150mg once monthly
3mg/3mL inj Treatment: 3mg IV once every
3mos
risedronate Actonel 5mg, 30mg, 35mg, 75mg, 150mg tab Prevention and Treatment: 5mg
once daily or 35mg once weekly
or one 75mg tab taken on
2 consecutive days per month or
150mg once a month
Atelvia 35mg delayed-release tabs Treatment: 35mg once weekly
zoledronic acid Reclast 5mg/100mL inj Treatment: 5mg IV infusion
once a year
Prevention: 5mg IV infusion
once every 2yrs
CALCITONIN
calcitonin-salmon 200 IU/spray nasal spray Treatment: 1 spray in alter-
nating nostril daily
Miacalcin 200 IU/spray nasal spray Treatment: 1 spray in alter-
nating nostril daily
200 IU/mL inj Treatment: 100 IU SC or IM
every other day
HORMONE REPLACEMENT THERAPY
conjugated estrogens Premarin 0.3mg, 0.45mg, 0.625mg, 0.9mg, 1.25mg tab 0.3mg daily; adjust
conjugated estrogens/
bazedoxifene
Duavee 0.45mg/20mg tab 1 tab daily
conjugated estrogens, then conjugated estrogens/
medroxypro-
gesterone
Premphase 0.625mg, then 0.625mg/5mg tab 1 tab once daily in correct order
(ie, 14 tabs of 0.625mg estrogen,
then 14 tabs of 0.625mg estrogen/
5mg of medroxyprogesterone;
repeat)
conjugated estrogens/
medroxypro-
gesterone
Prempro 0.3mg/1.5mg, 0.45mg/1.5mg, 0.625mg/
 
2.5mg, 0.625mg/5mg
tab 1 tab once daily
estradiol Alora 0.025mg/day, 0.05mg/day, 0.075mg/day, 0.1mg/day trans-
dermal patch
0.025mg/day patch applied
twice weekly; adjust
Climara 0.025mg/day, 0.0375mg/day, 0.05mg/day, 0.06mg/day, 0.075mg/day, 0.1mg/day trans-
dermal patch
0.025mg/day patch applied
once weekly; adjust
Estrace 0.5mg, 1mg, 2mg tab 0.5mg daily
Estraderm 0.05mg/day, 0.1mg/day trans-
dermal patch
0.05mg/day patch applied twice
weekly
Menostar 0.014mg/day trans-
dermal patch
0.014mg/day patch applied once
weekly
Minivelle 0.025mg/day, 0.0375mg/day, 0.05mg/day, 0.075mg/day, 0.1mg/day trans-
dermal patch
0.025mg/day patch twice
weekly (every 3–4 days); adjust
Vivelle 0.05mg/day, 0.1mg/day trans-
dermal patch
0.025mg/day patch applied
twice weekly
Vivelle-Dot 0.025mg/day, 0.0375mg/day, 0.05mg/day, 0.075mg/day, 0.1mg/day
estradiol, then estradiol/
norgestimate
Prefest 1mg, then 1mg/0.09mg tab 1 tab once daily in correct order
(ie, 3 tabs of estradiol, then 3 tabs
of estradiol + norgestimate, repeat)
estradiol/
levonorgestrel
Climara Pro 0.045mg/
 
0.015mg/day
trans-
dermal patch
1 patch once weekly
estradiol/
norethindrone
acetate
Activella 0.5mg/0.1mg, 1mg/0.5mg tab 1 tab once daily
estrone sodium sulfate (as estropipate) Ogen 0.625mg, 1.25mg, 2.5mg tab 0.625mg daily
estropipate Ortho-EST 0.75mg, 1.5mg tab 0.75mg once daily
norethindrone acetate/
ethinyl 
estradiol
Femhrt 0.5mg/2.5mcg,
1mg/5mcg
tab 1 tab once daily
INTERFERON
interferon
gamma-1b
Actimmune 100mcg/0.5mL SC inj BSA ≤0.5m²: 1.5mcg/kg/dose
3 times weekly
BSA >0.5m²: 50mcg/m² (1 mil-
lion IU/m²) 3 times weekly
OSTEOCLAST INHIBITOR (RANKL INHIBITOR)
denosumab Prolia 60mg/mL SC inj 60mg once every 6mos
PARATHYROID HORMONE
teriparatide Forteo 250mcg/mL SC inj 20mcg once daily
SELECTIVE ESTROGEN RECEPTOR MODULATORs (SERMs)
raloxifene Evista 60mg tab Prevention and Treatment:
60mg once daily
NOTES

Not an inclusive list of medications and/or official indications. Please see drug monograph at www.eMPR.com and/or contact company for full drug labeling.

(Rev. 2/2017)

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