Bone Health
General Bone Health Measures:
- Being as active as your health will allow
- Engage in weight-bearing exercise three times a week, such as walking or low impact aerobics
- Minimize fall risk, do not overdo exercise intensity
- Minimize your alcohol, caffeine, and/or tobacco intake
- Get enough calcium and vitamin D daily
Daily Calcium Requirements:
- Age 50+ = 1200 mg
- Age 65+ = 1500 mg
- Postmenopausal with hormonal replacement = 1000 mg
Daily Vitamin D Requirements:
- Adults = 200 IU
- Seniors = 400-800 IU
- Helps with calcium absorption
Which calcium product?
Calcium carbonate:
- 40% elemental calcium content
- Best taken with food
- Lower cost typically
Calcium citrate:
- 21% elemental calcium content
- Can be taken without regard to meals
- Preferred product for patients also taking acid reducers or antacids
Remember:
- Dietary calcium is the best source of calcium
- But if you are taking calcium supplements your doses should be divided so you are taking no more than 600 mg at a time. Otherwise it is an expense down the drain!
- Space calcium away from iron and fiber supplements and some antibiotics (ask your pharmacist or provider which ones)
What is a bisphosphonate?
- Bisphosphonates are a group of prescription drugs commonly used to treat osteoporosis. They help to decrease bone loss and can actually increase your bone mineral density which corresponds to your bone strength.
Which bisphosphonate is right for me?
- Only your healthcare provider can help you make the ultimate decision regarding how your osteoporosis or osteopenia will be best treated.
- The common bisphosphonates are listed below for your convenience.
Alendronate (Fosamax®)
- 35 mg weekly or 5 mg daily to prevent osteoporosis
- 70 mg weekly or 10 mg daily to treat osteoporosis
- Now comes in generic, except form with Vitamin D 2800 or 5600 IU included
Risedronate (Actonel®)
- 35 mg weekly or 5 mg daily for treatment or prevention
- New product: 150 mg monthly
Ibandronate (Boniva®)
- 150 mg monthly for prevention or treatment
Zoledronic Acid (Reclast®)
- 5 mg. given intravenously (IV line) over 15 minutes once a year
How do I take my bisphosphonate?
- Take first thing in the morning with a full glass of plain water.
- The amount of drug you absorb is lowered by food, coffee, or juice.
- Remain upright either sitting or standing for at least 30 minutes after taking your bisphosphonate.
- Space calcium, iron, magnesium, or antacids at least two hours afterwards.
- Bisphosphonates can only help protect your bones if your body has adequate calcium and vitamin D stores. This means you need to make sure you are getting the recommended daily amounts of calcium and vitamin D every day! This is one of the best bone health habits you can develop.
Please contact your pharmacist or provider if you have any questions or concerns.
