Bisphosphonates block bone resorption by inhibiting osteoclast activity. These agents significantly reduce vertebral and hip fractures by half in postmenopausal women
For all oral bisphosphonates, patients should take each tablet with 6 to 8 ounces of plain water first thing in the morning and at least 30 minutes before ingesting the first meal, beverage, or medication of the day.
Raloxifene is a selective estrogen receptor modulator that is used for both the prevention and the treatment of postmenopausal osteoporosis. It selectively inhibits or stimulates estrogen like action in various tissues. The dosage used is of 60 mg/d and it is known to decrease vertebral fractures by half
Salmon calcitonin nasal spray treats osteoporosis at a dose of 200 IU in alternating nostrils each day. It inhibits bone resorption.
Combination therapy: Risedronate and alendronate, as well as calcitonin, increase BMD when combined with hormone replacement therapy.
Combination therapy is recommended for patients who have severe osteoporosis and should be initiated and monitored by a bone specialist.