Other Drugs
Other drugs have limited scientific evidence for affecting fracture risk. These include:
- The use of acetaminophen (e.g., Tylenol) for 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 to treat heartburn. These over-the-counter medications may inhibit phosphate absorption from the intestine, reducing bone mineral density. In patients with impaired renal function, aluminum may impair bone mineralization, possibly 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 a 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. The effect on the skeleton is minimal when used for a short period, but long-term use 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.
