Osteoporosis Medications - Evaluating Risks Versus Benefits

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Dr. Vivien Brown, MD Local Family Physician discusses Osteoporosis Medications - Evaluating Risks Verses Benefits of Osteoporosis Medicine.

Dr. Vivien Brown, MD Local Family Physician discusses Osteoporosis Medications - Evaluating Risks Verses Benefits of Osteoporosis Medicine.

Video transcript

Featuring Dr. Vivien Brown, MDCM, CCFP, FCFP, NCMP, Family Physician Osteoporosis Medications - Evaluating Risks Verses Benefits Duration: 3 minutes, 8 seconds

People are always concerned when going on a medication about the possible side effects. In osteoporosis, drugs have been evaluated for quite some time and are considered extremely safe.

One of the side effects you may have heard about is osteonecrosis of the jaw, or ONJ. Although this is a very rare side effect on these medications, it has been reported in association of the medications, not necessarily as a side effect or cause.

Osteonecrosis of the jaw can happen approximately once in 100,000 people on these medications, and that by the World Health Organization is considered a very rare side effect. Remember, a hip fracture, a risk of fracture, is about one in four people over the age of 50. So fractures are very common, the risk of rare side effects is very rare.

When we look at osteonecrosis of the jaw, it’s more likely in people who smoke, who have an underlying cancer, who have poor oral hygiene, and in general if you have a concern absolutely you should discuss this with your physician. But as a practicing physician I am much more concerned about the risk of fracture and the need to treat fractures, which are so much more common in the general population.

A second very rare side effect is something called an atypical femoral fracture. This is a fracture that can occur in the thigh and has been associated with these medications, but not caused by these medications. Again, the numbers are very small, somewhere between two and eight per 100,000 people on medication.

Remember, the risk of fractures is somewhere around one in four to one in eight for women and men over the age of 50. Fractures are very common, and the need to treat them remains very important.

So if we want to put these clinical controversies - the risk of side effects from osteonecrosis of the jaw or atypical femoral fractures into perspective – what we can understand is that these are rare side effects.

Things that happen more commonly in everyday life include murders, include car accidents, and the reality is as a Canadian today you’re more likely to die from one of those events than you are of one of the side effects of the medications.

It’s a good idea to see your family doctor to look at information on osteoporosis, which comes from Osteoporosis Canada, and evaluate your personal risk so that you can decide with your primary care practitioner if you need medication to reduce your risk for fracture so that you can live a long and active life and not be disabled.


Presenter: Dr. Vivien Brown, Family Doctor, Toronto, ON

Local Practitioners: Family Doctor

Osteoporosis Medications - Evaluating Risks Verses Benefits. ( 46 participated.)

Test your knowledge by answering the following questions:


Your family physician can begin to diagnose osteoporosis by taking a full history from you including family history, medications you are taking and any health concerns you might have.


A change in height or posture can help your physician diagnose osteoporosis.


If you are diagnosed with Osteoporosis it is recommended that you avoid doing exercise.


If your physician suspects that you have osteoporosis, a bone mineral density test may be ordered which can determine what your true risk of having a fracture is.


If you are diagnosed with osteoporosis, seeing a nutritionist may be a good idea as both nutrition and exercise is crucial to it's treatment.

This content is for informational purposes only, and is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified healthcare professional with any questions you may have regarding a medical condition.

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