Other Drugs That Cause Osteoporosis

Using the WHO definition based on bone density measurement, it is estimated that there are roughly 10 million Americans over the age of 50 with osteoporosis of the hip, and 34 million others with osteopenia of the hip. Fracture is the most significant consequence of osteoporosis. Although osteoporosis can affect any bone in the body, the most typical sites of fractures related to osteoporosis are the hip, spine, and wrist.

Of the three most common sites of osteoporotic fractures, hip fracture poses the most significant insult to the health status of an individual. Increased mortality risk with hip fracture is related to comorbidities such as strokes or chronic lung diseases, poor health prior to the fracture and complications that arise secondary to medical/surgical treatment of the fracture.

Some medications cause either an increase in bone loss or a decrease in bone formation. The following medications are some that increase the risk of osteoporosis:

• Anticonvulsants - Anticonvulsants have also been linked to bone mineral density (BMD) decline. One of the primary mechanisms by which they induce this damage may be by preventing the conversion of vitamin D in to a hormone and thus reducing calcium absorption.
• Thyroid hormone - Hyperthyroidism can cause osteoporosis as well, decreasing BMD by 10% to 30% in women.
• Corticosteroids - corticosteroids are most often identified as a cause of osteoporosis. They are used frequently, in 0.5% of one population examined. Only a relatively small dose is needed to cause detrimental effects on BMD. One trial found less than 2.5 mg of prednisolone per day to be associated with an increased risk of fractures. BMD loss begins in the first weeks to months of therapy.
• Lithium - Lithium carbonate is a widely used drug for affective disorders. It may affect calcium metabolism. Patients treated with this medication might therefore be predisposed to osteoporosis.
• Immunosuppressants - Immunosuppressants, such as cyclosporine and tacrolimus have been shown to exert negative effects on bone density.
• Heparin - Many of the studies evaluating heparin’s effects on BMD and fracture risk have investigated women on heparin during pregnancy. One such study of 184 women, on 15,000 to 30,000 IU of heparin per day for 7 to 27 weeks, revealed symptomatic vertebral fractures in approximately 2% of these women
• Aluminum – Aluminium containing antacids and kidney patients who undergo dialysis and are prone for aluminium toxicity are more prone for osteoporosis. 
• Depo Provera - Depo Provera decreases estrogen levels. Over time, this can cause a loss of bone mineral density and increase the risk of osteoporosis.