The effects of medications on bone

J Am Acad Orthop Surg. 2007 Aug;15(8):450-60. doi: 10.5435/00124635-200708000-00002.

Abstract

Medications taken for the treatment of arthritis and psychotropic and epileptic disorders, as well as anticoagulants, antacids, bisphosphonates, corticosteroids, and antineoplastic drugs, can profoundly affect bone metabolism. In some scenarios (eg, osteoporosis), these effects are intended; in others (eg, rickets, osteomalacia secondary to antiepileptic drugs), potentially adverse side effects of medications on bone may occur. Nonsteroidal anti-inflammatory drugs appear to delay fracture healing and bone ingrowth, although these effects are reversible. Disease-modifying antirheumatic drugs do not appear to affect bone metabolism adversely when taken in the low dosages currently prescribed. Bisphosphonates are useful in restoring bone mass in cases of postmenopausal osteoporosis, glucocorticoid-induced osteoporosis, Paget's disease, and neoplastic conditions with bone loss and hypercalcemia. Corticosteroids and cancer chemotherapeutic agents generally affect bone adversely and increase fracture risk.

Publication types

  • Review

MeSH terms

  • Anti-Inflammatory Agents / adverse effects*
  • Antineoplastic Agents / adverse effects*
  • Antipsychotic Agents / adverse effects*
  • Bone Density / drug effects*
  • Bone and Bones / drug effects
  • Bone and Bones / metabolism*
  • Fractures, Bone / chemically induced*
  • Fractures, Bone / metabolism
  • Humans
  • Prognosis
  • Risk Factors

Substances

  • Anti-Inflammatory Agents
  • Antineoplastic Agents
  • Antipsychotic Agents