benefits and risks of osteoporosis medications

Summarize the benefits and risks of pharmacologic osteoporosis medications

• Benefits
  • Fracture reduction (significant for all FDA-approved agents).
• Risks
  • Common side effects:
    • Upper GI symptoms: oral bisphosphonates
    • Acute-phase reactions: IV bisphosphonates (first dose)
    • Transient decrease in serum calcium: zoledronic acid, denosumab
    • Transient increase in serum and urine calcium: teriparatide, abaloparatide
  • Uncommon/Rare side effects:
    • ONJ: antiresorptive agents
    • AFF: antiresorptive agents
    • Uveitis, keratitis, optic neuritis, orbital swelling: bisphosphonates
    • Atrial fibrillation: IV bisphosphonates
    • Hypercalcemia: teriparatide, abaloparatide