Antiresorptive medications for osteoporosis preserve the bone you have. They slow down the Osteoclast cells that eat away bone. They slow down “Osteoclasts Gone Wild”. This markedly slows down bone loss. They also slow down bone turnover. Slower bone turnover allows more Calcium to accumulate in the bone that you have. This can increase the Bone Mineral Density seen on DXA.
Bisphosphonates are by far the most common and best known Antiresorptives. Over 90% of persons taking Osteoporosis medication are taking Bisphosphonates. Bisphosphonates disable or kill the cells that eat away bone. This group includes the Oral Bisphosphonates: Fosamax, generic Alendronate, Actonel, and Boniva. The IV Bisphosphonates include IV Boniva, Reclast, and Zometa.
Prolia is a new type of Antiresorptive. It is a sub-Q (under the skin) shot twice a year. It prevents the cells that eat away bone from being formed or being activated. It can be given in patients with renal disease or older patients whose kidneys are slowing down.
Calcitonin (Miacalcin) is the oldest antiresorptive and is rarely used any more. Miacalcin can decrease spine pain in some Osteoporosis patients. Miacalcin has not been demonstrated to reliably increase Bone Mineral Density seen on DXA.
Jay Ginther, MD
2008 / Revised February 2011