This information is about osteoporosis drugs your doctor may prescribe to prevent or slow osteoporosis and to help build or rebuild bone. These drugs work to slow the action of osteoclasts (cells that break bone down) and/or to speed up the action of osteoblasts (forms new bone). The type of drug prescribed often depends on what is causing you to lose bone mineral density.

Listed below are several osteoporosis medications:

• Alendronate, alendronate plus Vitamin D
  • Both men and women can take it.
  • It can be used if your osteoporosis is caused by excessive corticosteroid use. (That's different from anabolic steroid use, such as what athletes do to build muscles mass. Corticosteroids are anti-inflammatories and are used to relieve pain.)
  • It slows down bone loss, thereby improving bone mineral density (BMD) and decreasing the risk of fractures in your spine, hip, and other bones.

• Calcitonin

  • Only women who are at least 5 years past menopause can take it.
  • It will slow down your rate of bone loss and build BMD specifically in the spine.

• Denosumab

  • This is used in post-menopausal women who are at high risk of fracture.
  • You should not use denosumab if you have low levels of calcium in your blood; this is called hypocalcemia.
  • This is given as an injection, and it's typically given every 6 months.  Your doctor will explain the specifics to you.

• Estrogen or hormone replacement therapy

  • This used to be the only FDA-approved way to treat osteoporosis, but that was in the late 1990s. Now, concerns about related risks of breast cancer, strokes, heart attacks, and blood clots mean that estrogen therapy isn't used as much. Your doctor will probably recommend a very low dosage or a very short amount of time.

• Ibandronate

  • Only women can take this.
  • It slows down bone loss, thereby improving BMD and decreasing the risk of fractures in your spine, hip, and other bones.

• Raloxifene

  • Only women can take this.
  • It specifically works to lower your risk of a spinal fracture as it increases bone density. As a bonus, it can also lower your risk for breast cancer (if you're a post-menopausal woman). However, as a side effect, it can cause hot flashes.

• Risedronate, risedronate with calcium

  • Both women and men can take it.
  • It can be used if your osteoporosis is caused by excessive corticosteroid use. (That's different from anabolic steroid use, such as what athletes do to build muscles mass. Corticosteroids are anti-inflammatories and are used to relieve pain.)
  • It slows down bone loss, thereby improving bone mineral density and decreasing the risk of fractures in your spine, hip, and other bones.
• Teriparatide, parathyroid hormone
  • Both women and men can take it.
  • It's the only medication listed here that actually increases your bone formation by stimulating the bone-forming cells to produce more bone. 
• Zoledronic acid
  • Only women can take this.
  • It slows down bone loss, thereby improving BMD and decreasing the risk of fractures in your spine, hip, and other bones. 

Drugs and Medications after a Spinal Fracture
Spinal fractures can be very painful—or maybe you won't feel pain at all. It all depends on what vertebra breaks and how it affects the rest of the spine. For example, the broken vertebra could pinch a nerve, causing you a lot of pain.

How much pain you have influences what drugs or medications you take. To deal with pain immediately following a fracture, you could try an over-the-counter medication:

• Acetaminophen: Tylenol is the brand name of acetaminophen, a type of medication that has proven to be a good pain reliever. Your doctor may call this an analgesic, but most of us refer to acetaminophen medications as painkillers. They don't help reduce inflammation, though.
• Over-the-counter NSAIDs (non-steroidal anti-inflammatory drugs): These will help reduce swelling (or inflammation) while relieving your pain; that's how NSAIDs differ from acetaminophen. If an over-the-counter NSAID is an option for you, you have plenty to choose from. You can use ibuprofen (Advil), naproxen (Aleve), or aspirin.

If you still have pain, your doctor may prescribe an NSAID, something stronger than what you can get over-the-counter.

A spinal fracture may also cause muscle spasms as your muscles have to work harder to support your spine while it heals. For that, your doctor may prescribe a muscle relaxant.

As with any drug or medication, please talk to a trusted medical professional before trying anything. You need to take into consideration your other medications and possible complications.