Elderly with Osteoporosis at Risk for Drug Interactions

  • As people get shorter, their medication list grows longer. As the medication list gets longer and people get older, the risk for drug interactions increases, so too does the risk of osteoporosis. Sometimes the treatments for osteoporosis can adversely interact with what is already on the medication list. Let’s take a look at some of the commonly prescribed drugs and how they can potentially interact with osteoporosis treatments.


    Diuretics (hydrochlorothiazide, lasix, amiloride): These “water pills” have the potential to increase the risk of kidney damage when you are also taking a Bisphosphonate ( Fosamax, Actonel, Boniva, Reclast) medication. The key to preventing this problem is to stay hydrated. Some particular points to also be aware of is that the diuretic medications can also affect the calcium levels in the blood. So if you are trying to increase your calcium levels by taking a calicium supplement, the “water pills” might be flushing your efforts down the toilet, literally.

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    NSAID (ibuprofen, Advil, Aleve): The common anti-inflammatory medications can also be hard on the kidneys especially when you are taking a drug like a Bisphosphonate that can also impact the kidneys. Again, this accumulative risk is reduced if you are drinking plenty of water. 1


    Cholesterol-Lowering Medication (cholestyramine, colestipol, colesevelam): A special subclass of medications used to lower cholesterol called the “bile acid sequestrants” can impact the absorption of the calcium supplements.


    Digoxin: This very common medication used to treat heart rhythm irregularities is very sensitive to calcium levels in the blood. Anyone who is taking a calcium supplement and digoxin should have the calcium levels monitored closely.


    Coumadin: Many elderly people use Coumadin to thin the blood after having a stroke or heart condition diagnosed. Coumadin also interacts with a popular medication used to treat osteoporosis called Evista (raloxifene). Because bleeding risks can be increased when someone is using both Coumadin and Evista, doctors should monitor PT times closely.


    Levothyroxine (Synthroid, Levoxyl):  Many people take a thyroid medication called Levothyroxine. Some of those who take both levothyroxine and raloxifene (Evista) have noticed sudden changes in their thyroid levels. Watch out. Notify your doctor if you notice a difference in the way you feel after starting Evista when you are also taking thyroid medications.1


    Bisphosphonates: These common medicines used to treat osteoporosis can reduce the absorption of calcium. So can strontium ranelate. Separate the osteoporosis drugs from the calcium supplements to get the best effect from both.1,2


    Most of these interactions are rare, but the potential still exists. So you need to be aware and stay safe especially as your medication list grows longer and you get shorter and older.



    1. Calcif Tissue Int. 2011 August; 89(2): 91–104.
    2. Clin Cases Miner Bone Metab. 2010 Jan-Apr; 7(1): 17–18
Published On: July 25, 2012