Osteoporosis and polypharmacy.
Osteoporosis is very common in elderly patients. Despite the severe health-related consequences for individual patients and the socioeconomic costs caused by osteoporotic fractures, treatment rates are still low. Due to drug interactions and patient compliance, polypharmacy is often mentioned as a reason for undertreatment. Several drugs have a direct or indirect effect on bone metabolism. The present paper discusses the risk of interactions of anti-osteoporotic drugs (oral and parenteral bisphosphonates, raloxifene, strontium ranelate, teriparatide, and denosumab) with other common medications in elderly patients and their impact on bone metabolism and fracture risk. In summary, the number and risk of drug interactions of all common anti-osteoporotic drugs are small and clinically rather irrelevant. However, patients with a polypharmacy are at a higher risk of fractures and should receive osteoporosis treatment, if indicated.
Abt. für Innere Medizin und Akutgeriatrie, Landeskrankenhaus Hochzirl, Hochzirl 1, 6170, Zirl, Österreich. markus.gosch@tilak.at
M
M
Gosch
M
M
Jeske
C
C
Kammerlander
T
T
Roth
D000368:Aged; D000369:Aged, 80 and over; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D004347:Drug Interactions; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D010024:Osteoporosis / Q000453:epidemiology* / Q000517:prevention & control; D058866:Osteoporotic Fractures / Q000453:epidemiology* / Q000517:prevention & control; D019338:Polypharmacy; D018570:Risk Assessment; D012307:Risk Factors
D050071:Bone Density Conservation Agents