Ask Your Pharmacist about osteoporosis

Every year, the National Pharmacy Association (NPA) run Ask Your Pharmacist (AYP) Week - a public awareness campaign for community pharmacies across the UK. To celebrate this year’s AYP Week (31 October – 7 November), we chat to NPA’s Pharmacy Advice and Support Services team to understand how pharmacists support people with osteoporosis.

What is the role of a pharmacist in supporting someone with osteoporosis and fractures (broken bones)?

Pharmacists are one of the most accessible healthcare professionals as no appointment is usually required to see one. People living with osteoporosis and fractures (broken bones) can approach community pharmacists for information and guidance on the day-to-day management of the condition.

Pharmacists can advise about medication prescribed for osteoporosis, including any drugs that don’t work together or cause side effects or health risks. They can provide lifestyle information and advice such as taking regular exercise (tailored to the person) to help strengthen muscle and bone, eating a balanced diet as this may improve bone health, ways to reduce chances of a fall, and how to help recover from a fracture.

How do I manage taking my various medicines and supplements for osteoporosis?

Bisphosphonates are one group of medicines used to treat osteoporosis and are available as tablets or injections. Oral bisphosphonates can cause inflammation in the food pipe so it's very important that you carefully follow the instructions for taking this medicine. As food, drink and other medicines can affect the absorption of oral bisphosphates, they must be taken on an empty stomach.

Alendronate is an oral bisphosphonate that must be taken at least 30 minutes before the first food, other medicine, or drink (other than plain water) of the day. The tablet must be swallowed whole with a glass of plain water (at least 200mls) while you are in an upright position. You must stand or sit upright for 30 minutes after taking the medication. Weekly preparations should be taken on the same day each week.

Risedronate is also a bisphosphonate that should be taken before breakfast at least 30 minutes before the first food, other medicine, or drink (other than plain water) of the day. If it is not practical to take medicines before breakfast, talk to your pharmacist about alternative ways to get the best from your medicine.

If you have difficulty swallowing tablets, you can try the NHS’s ‘lean forward’ or ‘pop bottle’ techniques.

Calcium supplements, antacids, food and drink can reduce the absorption of bisphosphonates so a minimum of 30 minutes should be left between taking a bisphosphonate and calcium supplements, antacid and food or drink.

Read more about the different osteoporosis drug treatments

I’ve been prescribed one of my usual medicines with a different brand name – why has this happened, and will there be any difference in terms of side effects?

The general versions will be the same as the branded medicine because they contain the same active ingredients and therefore have the same effect. However, the two may contain different added ingredients for example, the sugar, flavouring, and colouring may be different from the ones used in the branded medicine. Patients who have known allergies to these should discuss this with their pharmacist.

I’ve had a reaction to my medication, can you help me report this to the company that makes the drug?

If you experience a side effect to a medication, you can talk to your pharmacist. It is important to report suspected side effects with medicines to the Medicines and Healthcare Regulatory Agency (MHRA) using the Yellow Card Scheme. The Yellow Card Scheme is an essential tool that the MHRA uses to monitor the safety of medicines, medical devices and herbal or complementary medicines. The scheme helps to improve patient safety by identifying issues such as side effects, as well as faulty and counterfeit medicines or medical devices. Both patients and pharmacists can report side effects that are experienced with medicines using the Yellow Card Scheme. Reporting can be done though the Yellow Card website or app, or by post or email. All personal information will be kept confidential and will not be shared without your consent.

I’ve heard about medicine reviews – what are these and what is the pharmacist’s role?

The Medicines Use Review (MUR) service was discontinued on 31 March 2021.

There is a new service in England, the NHS New Medicine Service. If you have any of a list of conditions (including osteoporosis), you can get extra advice from your pharmacy team when you start taking a new drug treatment to manage osteoporosis and its symptoms. New medications can be quite confusing so the pharmacist will offer support during three appointments over a month to check you’re taking the drug correctly. You may be referred back to your GP if there’s an issue requiring a change to the prescription.

Visit the Ask Your Pharmacist Week web page for more details, including an ‘Ask your pharmacist about osteoporosis’ video.