Finding the right osteoporosis treatment 

Osteoporosis medicines help strengthen bones, making them less likely to break. These medicines are an effective treatment for osteoporosis and help you to stay independent and live well. 

Osteoporosis medicines are not pain-relieving. This means they will not reduce the pain caused by broken bones. There are other treatments and ways to manage pain from broken bones.

It is normal to feel worried or have questions about starting a new medicine. It is your choice whether to have the medicine.

We answer some common questions to help you understand the benefits and possible risks – both of taking a medicine and of not taking one.

This information may be helpful if you (or someone close to you) are deciding whether to:

• start an osteoporosis medicine for the first time
• change your osteoporosis medicine.

Get tailored support with our free medicine support service, BoneMed Online. This service can help you if you have already started taking an osteoporosis medicine.

How do I make a decision about taking an osteoporosis medicine?

It is helpful to think about what is important to you. Consider these questions and talk to your healthcare professional if you are unsure. 

• Do you feel you know enough about osteoporosis and your bone health?
• Do you feel you know enough about the possible benefits and side effects?
• Are you worried about side effects?
• Can you imagine yourself taking the medicine?
• Are there any practical things that might make taking the medicine difficult?
• How would you feel if you decided not to take the medicine and then broke a bone?

It is important to learn all you can about your treatment options, so you can decide what is right for you.

Talk to a healthcare professional so you fully understand your situation. You can ask them as many questions as you need about your medicine. They are there to help you find the best treatment for you.

You should get a patient information leaflet with your treatment. This leaflet contains important information about your medicine. If you do not have a copy, ask your healthcare professional for one.

Read our tips on how to get the most from your appointment when talking to your GP about your medicine.

Watch our video about making a decision about osteoporosis medicine with Professor Zoe Paskins at Keele University:

Why have I been offered a medicine for osteoporosis?

A healthcare professional will offer you an osteoporosis medicine if your chance of breaking a bone is high enough that you would benefit from a medicine.

Before recommending a medicine, your healthcare professional will consider lots of things, including:

• your age and gender
• if you have broken any bones before
• if you have any other medical conditions
• the different types and forms of medicines available
• your own thoughts and feelings about treatment.

All this helps them understand your needs and the medicine that is likely to work best for you.

 

Is there a natural alternative to osteoporosis medicine?

People often want to know if they can improve their bone strength without taking a medicine. Healthy habits, like a balanced diet and regular exercise, are important for your bone health. But if you have a high chance of broken bones, the best way to reduce your chance of a broken bone is to take an osteoporosis medicine and have healthy habits.

 

What are my osteoporosis treatment options?

Everyone’s treatment journey is different. There are several types of medicines for osteoporosis. The most common medicines are bisphosphonates. Alendronate (a bisphosphonate) is usually the first medicine that people are offered. But this may be different for you.

There are some cases where bisphosphonates may not be suitable. Some people may need to try a different medicine to find one that feels right. Your healthcare professional can help you find the most suitable medicine for you.

Osteoporosis medicines are available in different forms, including:

• tablets
• soluble tablets
• liquid medicines
• intravenous infusion (IV or ‘drip’)

Find out more about the different treatment options.

 

Do osteoporosis medicines cause side effects?

All medicines can cause side effects, even your everyday medicines like paracetamol. Most people will not experience any problems. Especially if the medicine is taken correctly.

Most osteoporosis medicine side effects are mild. They will often disappear after a short time. Some side effects can happen after years of taking an osteoporosis medicine. But these are very rare.

Talk to a healthcare professional if you do get side effects that do not go away. They may be able to change you to another osteoporosis medicine which is better for you.

It is normal to feel worried about side effects. It is important to remember why you were offered a treatment. It is because your chance of breaking a bone without treatment is higher than your chance of experiencing a side effect.

It can also help to know that all medicines in the UK have been tested in research to ensure they are safe to take.

Watch our video about understanding the side effects of osteoporosis medicines:

What will happen if I do not have an osteoporosis medicine?

If you decide not to take an osteoporosis medicine, it is likely your bones will get weaker over time. This means your chance of breaking a bone will increase.

Some people may never break any bones, while others may break several. Everyone’s chance is different. It is important to understand your own situation and make a decision that is right for you.

 

How long should I take my osteoporosis medicine for?

Osteoporosis medicines are normally taken for several years. You may be on the same medicine during this time or swap to a different medicine.

Your healthcare professional should review your osteoporosis medicine and bone strength every three to five years. For bisphosphonates and denosumab, this is particularly important to lower the chance of side effects.

At your review, your healthcare professional will ask about any side effects. They will also check your treatment is working.

Before you start denosumab, it is very important to plan ahead with your doctor. You will need to have another medicine if you stop taking it. This is because denosumab wears off quickly. Stopping denosumab can cause broken bones if you do not switch to another osteoporosis medicine.

 

How do I know if my osteoporosis medicine is working?

You will not feel any different when taking an osteoporosis medicine. But this does not mean it is not working. Research shows they are working in the background. They are helping to strengthen your bones and stop them from breaking.

Healthcare professionals can also check if your medicine is working. They may ask you if you have:

• broken any bones while taking the treatment and how many
• got shorter or your posture has changed. This is because spinal fractures can cause height loss.

You may be offered a bone density scan two to five years after you start your medicine. This is to help see if the medicine is working.

Bone density scans only show one part of what is happening in the bones. Medicines can improve bone strength in ways that are not measured by the scan.

If you break a bone while taking your treatment, it does not necessarily mean the medicine is not working. No medicine completely prevents broken bones, it just lowers the chance. But if you continue to break bones easily, your healthcare professional may recommend a different medicine.

 

Can I stop taking my osteoporosis medicine?

You can stop taking osteoporosis medicine. But it is important to talk to your healthcare professional if you stop. Do not stop denosumab without talking to a doctor first.

Your healthcare professional may recommend you pause your medicine. This is if you have been taking a bisphosphonate for a few years. Your medicine will continue to strengthen bones for a few years after you stop taking it. After a few years, your healthcare professional may advise you to start it again, if it would benefit your bones.

 

How do I get the best out of my osteoporosis medicine?

Your healthcare professional will tell you when to take your medicine and how often. There are many things you can do to get the most out of your treatment.

• Take the treatment for the amount of time advised by your doctor. Try to fit the medicine into your routine.
• Read the instructions that come with your treatment and follow them carefully. This will lower the chance of side effects and ensure your medicine works to its full potential.
• Eat a well-balanced diet. Your healthcare professional may also prescribe you calcium and vitamin D. Calcium gives your bones strength and vitamin D helps you absorb calcium.
• Visit BoneMed Online, our free medicine support service. We can support you if you are starting, taking or changing osteoporosis medicine.

If you have problems or side effects, talk to your healthcare professional. You may be able to try a different medicine that feels better for you. If one medicine has not worked for you, another one might.

 

Content reviewed: November 2025

Date of next review: November 2028