pharmaceutical agents that cause bone loss
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Etiology
- anticonvulsants
- phenytoin, phenobarbital, carbamazepine, primidone induce cyt P450 isozyme(s) (cyt P450 3A4?) that enhance metabolism of vitamin D, androgens & estrogens
- valproic acid may increase renal Ca+2 excretion
- immunosuppressants
- glucocorticoids
- reduce Ca+2 absorption & increase Ca+2 excretion
- inhibit osteoblasts & activate osteoclasts
- suppress androgens & estrogens
- cyclosporine & tacrolimus increase bone resorption
- methotrexate at higher doses reduces osteoblast activity
- glucocorticoids
- GNRH analogs (leuprolide, nafarelin) antagonize androgen & estrogen
- thyroxine (excessive)
- vitamin A (> 10,000 IU/day)
- vitamin D (> 2000 IU/day) increases bone resorption
- antidepressants
- nicotine (smoking)[2]
- proton pump inhibitor, prolonged use (> 1 year)[2]
- thiazoladinediones[3]
More general terms
References
- ↑ Prescriber's Letter 11(8): 2004 Drugs and Supplements that Cause Bone Loss Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=200820&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 2.0 2.1 2.2 2.3 Geriatrics at your Fingertips, 13th edition, 2011 Reuben DB et al (eds) American Geriatric Society
- ↑ 3.0 3.1 NEJM Knowledge+ Endocrinology
Singh S, Furberg CD. Long-term use of thiazolidinediones and fractures in type 2 diabetes: a meta-analysis. CMAJ. 2009 Jan 6;180(1):32-9. Epub 2008 Dec 10. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19073651 PMCID: PMC2612065 Free PMC article - ↑ 4.0 4.1 Viscoli CM et al. Pioglitazone and risk for bone fracture: Safety data from a randomized clinical trial. J Clin Endocrinol Metab 2017 Mar; 102:914 PMID: https://www.ncbi.nlm.nih.gov/pubmed/27935736 https://academic.oup.com/jcem/article-abstract/102/3/914/3061916/Pioglitazone-and-Risk-for-Bone-Fracture-Safety