1. Medication for osteoporosis

2. Bisphosphonates
Bisphosphonates slow down the rate at which bone is broken down in your body. This maintains bone density and reduces the risk of fracture.
There are a number of different bisphosphonates, including
alendronate
etidronate
ibandronate
risedronate
zolendronic acid
They're given as a tablet or injection.

3. You should always take bisphosphonates on an empty stomach with a full glass of water. Stand or sit upright for 30 minutes after taking them. You'll also need to wait between 30 minutes and two hours before eating food or drinking any other fluids.
Bisphosphonates usually take 6 to 12 months to work and you may need to take them for five years or longer. You may also be prescribed calcium and vitamin D supplements to take at a different time to the bisphosphonate.

4. The main side effects associated with bisphosphonates include:
irritation to the oesophagus (the tube that food passes through from the mouth to the stomach)
swallowing problems (dysphagia)
stomach pain
Not everyone will experience these side effects.

5. Strontium ranelate
Strontium ranelate appears to have an effect on both the cells that break down bone and the cells that create new bone (osteoblasts).
It can be used as an alternative treatment if bisphosphonates are unsuitable. Strontium ranelate is taken as a powder dissolved in water.

6. The main side effects of strontium ranelate are nausea and diarrhoea
The main side effects of strontium ranelate are nausea and diarrhoea. A few people have reported a rare severe allergic reaction to the treatment. If you develop a skin rash while taking strontium ralenate, stop taking it and speak to your doctor immediately.

7. Selective oestrogen receptor modulators (SERMs)
SERMs are medications that have a similar effect on bone as the hormone oestrogen. They help to maintain bone density and reduce the risk of fracture, particularly of the spine.
Raloxifene is the only type of SERM that's available for treating osteoporosis. It's taken as a tablet every day.

8. Side effects associated with raloxifene include:
hot flushes
leg cramps
a potential increased risk of blood clots

9. Parathyroid hormone (teriparatide)
Parathyroid hormone is produced naturally in the body. It regulates the amount of calcium in bone.
Parathyroid hormone treatments (human recombinant parathyroid hormone or teriparatide) are used to stimulate cells that create new bone (osteoblasts). They're given by injection.
While other medication can only slow down the rate of bone thinning, parathyroid hormone can increase bone density. However, it's only used in a small number of people whose bone density is very low and when other treatments aren't working.

10. Nausea and vomiting are common side effects of the treatment
Nausea and vomiting are common side effects of the treatment. Parathyroid hormone treatments should only be prescribed by a specialist.

11. Calcium and vitamin D supplements
Calcium is the major mineral found in bone, and having enough calcium as part of a healthy, balanced diet is important for maintaining healthy bones.
For most healthy adults, the recommended amount of calcium is 700 milligrams (mg) of calcium a day, which most people should be able to get from a varied diet that contains good sources of calcium.

12. However, if you have osteoporosis you may need more calcium, which will usually be in the form of supplements. Ask your GP for advice about taking calcium supplements.
Vitamin D is needed to help the body absorb calcium. All adults should consume 10 micrograms (mcg) of vitamin D a day.
Because vitamin D is found only in a small number of foods, it might be difficult to get enough from foods that naturally contain vitamin D and/or fortified foods alone. So all adults should consider taking a daily supplement containing 10mcg of vitamin D.

13. Hormone replacement therapy (HRT)
HRT is sometimes recommended for women who are experiencing the menopause, as it can help control symptoms.
HRT has also been shown to maintain bone density and reduce the risk of fracture during treatment.
However, HRT isn't specifically recommended for treating osteoporosis and it isn't often used for this purpose.
This is because HRT slightly increases the risk of developing certain conditions, such as breast cancer, endometrial cancer, ovarian cancer, stroke and venous thromboembolism more than it lowers the risk of osteoporosis.

14. Testosterone treatment
In men, testosterone treatment can be useful when osteoporosis is caused by insufficient production of male sex hormones (hypogonadism).

15. Denosumab (Prolia, Xgeva) is a newer medication shown to reduce the risk of osteoporotic fracture in women and men. Unrelated to bisphosphonates, denosumab might be used in people who can't take a bisphosphonate, such as some people with reduced kidney function.

16. Abaloparatide (Tymlos) is the newest osteoporosis medication
Abaloparatide (Tymlos) is the newest osteoporosis medication. Like teriparatide, it has the potential to rebuild bone. In a research trial comparing these two treatments, abaloparatide appeared to be as effective as teriparatide but was less likely to cause an excess of calcium.