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6.6 Drugs affecting bone metabolism

General Notes

  • Refer to NICE Pathway – Osteoporosis.
  • Consider risk assessment using FRAX or QFracture.
  • Consider falls prevention measures. The greatest risk of fracture in the elderly comes from falls, not osteoporosis.
  • For the management of glucocorticoid-induced osteoporosis, refer to the Royal College of Physicians treatment algorithm. Patients receiving 7.5mg or more of prednisolone daily for longer than 3 months should receive osteoporosis prophylaxis.
  • Male osteoporosis is often secondary to other medical conditions; specialist referral is recommended.