MedicationsandBoneLoss

Fact Sheet

Medicines and Bone Loss

  • Editors
  • Jens Bollerslev, MD
    Steven T. Harris, MD
    Benjamin Z. Leder, MD

Some types of medicines can cause bone loss, making your bones weak, if used for a long time.  Use over a short time is usually not a problem. When you have weak bones—a condition called osteoporosis—your risk of bone fractures goes up.  Broken bones can lead to pain and disability.  For example, some older people who break a hip may lose their ability to function independently.

Osteoporosis

Which medicines can cause bone loss?

A number of medicines can cause bone loss if used over the long term (several years).  Some common ones include

Other Medicines That May Cause Bone Loss
Medicine
  • Antacids that contain aluminum
  • Chemotherapy drugs
  • Cyclosporine and tacrolimus
  • Heparin
  • Loop diuretics such as furosemide and torsemide
  • Medroxyprogesterone acetate
  • Methotrexate
  • Thiazolidinediones such as pioglitazone and rosiglitazone
Used For
  • Heartburn
  • Cancer
  • Preventing rejection of organ transplant
  • Preventing blood clots
  • Heart failure, edema (tissue swelling), some kidney problems
  • Contraception
  • Cancer and rheumatoid arthritis
  • Diabetes

Some people who take thyroid hormone worry about bone loss.  The doses of thyroid hormone used to treat hypothyroidism (underactive thyroid) don’t harm bone and shouldn’t be cause for concern. Only high doses, used for thyroid cancer treatment, can cause bone loss. 

High doses or long-term use of medicines called proton pump inhibitors (PPIs) can raise the risk of bone loss. PPIs, such as esomeprazole, lansoprazole, and omeprazole, are used for GERD (acid reflux), peptic ulcer, or heartburn.  However, getting enough calcium and vitamin D may be enough to lower the risk.   

Did you know?

Normally, your body continuously removes old bone and replaces it with new bone. Bone loss occurs when old bone breaks down faster than new bone can form.

Experts don’t know yet whether selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine and escitalopram, increase fracture risk.  Some studies show a small effect on bone but others do not.  SSRIs are used for depression and obsessive-compulsive disorder.  Talk to your doctor if you take an SSRI and are concerned about bone loss.

How is bone strength measured?

A bone mineral density test called a DEXA scan—a type of very low dose X-ray—checks bone mass (the amount of calcium and other minerals in your bones).  This test can show early bone loss before the more serious condition of osteoporosis occurs. 

What can I do to prevent bone loss and avoid fractures?

Talk with your doctor about what’s best for you.  Your doctor may advise you about

Questions to ask your doctor

Resources