Medicines and Falls
Medicines Causing Bone Loss
Medicines for Bone Health
Take Charge of Medicines and Bone Health
     Medicine Questions for My Doctor and My Pharmacist
     Medication Summary Card

Medicines and Falls
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Some medicines can cause dizziness and increase the risk of falling.  Medicines that may increase the risk of falling include blood pressure medicine, heart medicine, diuretics or water pills, muscle relaxers, tranquilizers, and strong pain medicines. 

Ask your doctor and/or pharmacist whether or not any of your medicines might cause you to feel dizzy, drowsy, or to lose your balance.  If so, then find out from them what you should do about medicines that might make you dizzy.  Be sure to make no changes in your medicine unless told to do so by your doctor.

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Medicines Causing Bone Loss
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Some types of medicines speed up bone loss, while other medicines help slow bone loss.

Medicines that speed up bone loss are in the group known as glucocorticoids.  These are also called steroids (or corticosteroids, such as prednisone, cortisone, dexamethasone, cortisol).  They increase calcium loss from the body, which can increase the risk of broken bones and fractures with long-time use.  Steroid medicines are used for arthritis, inflammatory bowel disease, asthma, allergies, and other respiratory (lung) or inflammatory diseases.

Other medicines can harm bones when used in high doses and/or for a long time.  These include antacids with aluminum, thyroid hormones, laxatives, some diuretics (water pills), and heparin (which is a blood thinner given through your veins).  Some of these medicines disrupt calcium in the body.

Ask your doctor or pharmacist if any of your medicines might speed up bone loss.  If so, then ask whether or not there is anything that should be done about this.  Also, ask your doctor or pharmacist if you should be taking medicines that will help your bones, such as those listed on the handout.  

Medicines for Bone Health
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There are medicines that can slow bone loss.  These drugs work properly when consuming adequate calcium and vitamin D from foods and/or supplements.  Talk to your doctor to see if you might benefit from medicines such as these:

1. Fosamax® and Actonel® are prescription drugs that help stop bone loss and can actually increase bone density.  Boniva® is also in this category and is taken only once a month.  Talk with your doctor about any of these medicines if you are concerned about bone loss.
2. Calcitonin is a prescription drug usually available as a nasal spray (e.g., Miacalcin®).  It can help prevent bone loss.  For calcitonin to work, you must also take 1,000 mg of calcium per day and use the nasal spray exactly as directed. 
3. Estrogen Replacement Therapy or Hormone Replacement Therapy is for womenandcan help improve bone health by helping the body use calcium and reduce bone loss.  Once estrogen replacement is started, it must be continued to prevent the return of bone loss.  If estrogen or hormone therapy is stopped, bone loss will be similar to that seen in early menopause.  Estrogen or hormone replacement therapy is not for everyone.  Anyone considering it should talk to her doctor about risks and benefits.  The Food and Drug Administration has made the following recommendations concerning estrogen therapy replacement and hormone therapy:
   • Take the lowest possible doses for the shortest period of time to manage symptoms of menopause.
   • Talk about using other osteoporosis medicines instead.

Ask your doctor how much calcium and vitamin D as dietary supplements you should take with these medicines, because they will work best along with calcium and vitamin D.

Take Charge of Medicines and Bone Health
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October is “Talk About Prescriptions Month.”  It is a good time to talk with your doctor about your medicines and bone health. You can use the "Medication Summary Card" to write down all the medicines you are taking and then talk with your doctor at your next appointment. The handout titled “Medication Questions for My Doctor and My Pharmacist” lists many questions you should ask about your medicines.

So remember, the next time you visit your doctor and pharmacist, be sure to bring them copies of the “Medication Summary” card and the “Medication Questions for My Doctor and My Pharmacist.”  This will help you manage your medicines better. 

Medicine Questions for My Doctor and My Pharmacist
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Review this handout and bring it to your doctor or pharmacist.  Before your next appointment with your doctor or pharmacist, let them know ahead of time that you need extra time with them to review your medicines.  Don’t be shy about asking questions.  Your medicines can greatly affect your health, for better or worse, so it is important that your questions and concerns are answered.  It is important to go to only one pharmacy so that your pharmacist can help make sure that your medicines work safely together.

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Medication Summary Card
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Be sure to include prescription medicines, over-the-counter medicines, vitamin and mineral supplements, and herbal supplements.  You can fill this out now or take it home with you. 

Give a copy of your “Medication Summary” card to your doctor, pharmacist, senior center, and anyone else who helps you take care of yourself, such as siblings, children, or caregivers.  Keep one copy with you and one at home.  That means you should make about five copies so that everyone who needs one will have it! 

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