Medications for Osteoporosis

In New Zealand, medications available for managing osteoporosis include the following:

• Alendronate and Risedronate: These oral bisphosphonates, taken as tablets weekly, are first-line treatments that reduce the risk of vertebral, hip, and other fractures by inhibiting bone resorption.
• Zoledronate: This intravenous bisphosphonate is increasingly used as a first-line treatment due to its convenience—requiring only an annual or 18-monthly infusion. However, an infusion fee may be charged in some regions of the country, which could be a barrier for some patients.
• Denosumab: Administered as a subcutaneous injection every six months, this medication is an option for patients with renal impairment or those who cannot tolerate bisphosphonates.
• Teriparatide: A daily subcutaneous injection that stimulates bone formation, used for severe osteoporosis in patients with multiple fractures.
• Raloxifene: A selective oestrogen receptor modulator (SERM) that reduces vertebral fracture risk in postmenopausal women.
• Hormone Replacement Therapy (HRT): Primarily used for managing menopausal symptoms, HRT can also help maintain bone density in postmenopausal women, particularly when started within 10 years of menopause (typically between ages 40 to 60). HRT is available in various forms, including tablets and skin patches, allowing for tailored treatment options based on individual patient needs.

Each treatment option requires careful consideration of the patient’s preferences and potential barriers to adherence.

Select osteoporosis medications based on patient preferences and needs to ensure the best outcomes and adherence to treatment.

Product datasheets are available from the Medsafe website at medsafe.govt.nz.

Pharmac Special Authority Forms are available from the Pharmac website at schedule.pharmac.govt.nz/SAForms.php.

The Guidance on the Diagnosis and Management of Osteoporosis in New Zealand offers clinicians in primary and secondary care a practical, evidence-based tool for managing osteoporosis and is available from here.

The New Zealand Doctor published an article titled “How to Treat Osteoporosis” by Dr. David Kim, Consultant Endocrinologist, Te Whatu Ora – Health NZ Waitematā. This How to Treat has been endorsed by the RNZCGP and has been approved for up to 1 credit for continuing professional development purposes (1 credit per learning hour). The Nursing Council of New Zealand has also endorsed this as a professional development activity (up to 1 PD hour).

The article and associated assessment are freely available from nzdoctor.co.nz/educate/osteop.