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Drugs to treat osteoporosis
Consumer-Report-Logo Comparing effectiveness, safety, and price

Summary recommendations

Advice and Recommendations from Consumer Reports Best Buy Drugs

Several types of medication are used to prevent fractures in people with osteoporosis, or “thinning” bones. Some are more effective at preventing certain types of fractures than others. But there’s little evidence that these medications will help if you have osteopenia, sometimes called “pre-osteoporosis,” which is bone density that’s lower than normal but not severe enough to be called osteoporosis.

In those cases, instead of medication, consider lifestyle changes. That includes making sure that your diet has adequate amounts of calcium and vitamin D, and doing weight-bearing exercise, such as walking or lifting weights. Also take precautions to prevent falls in the first place, such as limiting how much alcohol you drink and avoiding sleeping pills if possible. Consider medication only if your bone density worsens to the point where you have osteoporosis—although it’s still important to continue the lifestyle changes.

If your doctor diagnoses osteoporosis and recommends medication, we suggest the following Best Buy Drug after taking into account effectiveness, safety, convenience, and cost.

Generic alendronate

The drug is available as a generic that costs $39 to $63 a month, depending on the dose. It has been shown to help prevent fractures of the hip, spine, and other bones in those with osteoporosis. It’s usually well tolerated, but as with all bisphosphonates, the "class" of drugs to which alendronate belongs, the most common side effects include diarrhea, nausea, vomiting, heartburn, esophageal irritation, and bone, joint, or muscle pain. Bisphosphonates can also cause rare but serious side effects that include permanent bone deterioration of the jaw (osteonecrosis) and, when taken for more than five years, a possible increased risk of thigh fracture. So talk with your doctor about how to reduce your risk of side effects.

Most studies of alendronate and the other osteoporosis medications have involved postmenopausal women with osteoporosis, so it’s not clear how well they work for men or younger women.