Other Drugs
There are other drugs that have limited scientific evidence for affecting fracture risk. These include:
- The use of acetaminophen (e.g. Tylenol) for a period of at least 3 years (dose uncertain) compared to non-users has been associated with an increased risk of fracture.
- Aluminum-containing antacids such as Maalox, Mylanta, Amphogel, Gelusil, and Rolaids are often taken for the treatment of heartburn. These over-the-counter medications may inhibit phosphate absorption from the intestine, which may reduce bone mineral density. In patients with impaired renal function, the aluminum may impair bone mineralization and this may be associated with fractures.
- Thiazolidinediones such as rosiglitazone (Avandia) and pioglitazone (Actos) are drugs used to treat type 2 diabetes. In men and women aged 40 years and older who were started on these drugs, there was an increased risk of fracture and this risk increased with longer duration of thiazolidinedione use (4 years or more).
- Antirejection/immunosuppressive therapy such as cyclosporine (Neoral) and tacrolimus (Prograf) used after organ transplant may increase bone loss.
- Heparin is a blood thinner. When used for a short period of time the effect on the skeleton is minimal, but with long-term use, it may reduce bone density.
- Some cancer chemotherapy drugs may cause ovarian failure in women, resulting in premature menopause, or testicular failure in men, resulting in low testosterone levels, both of which lead to bone loss. In addition, some cancer treatments include glucocorticoid therapy which may further increase bone loss.
