Drug-induced osteoporosis: mechanisms and clinical implications

Am J Med. 2010 Oct;123(10):877-84. doi: 10.1016/j.amjmed.2010.02.028.


Drug-induced osteoporosis is common and has a significant impact on the prognosis of patients suffering from chronic debilitating diseases. Glucocorticoids are the drugs causing osteoporotic fractures most frequently, but osteoporosis with fractures is observed also in women treated with aromatase inhibitors for breast cancer, in men receiving anti-androgen therapy for prostate cancer, in postmenopausal women treated with high doses of thyroxine, and in men and women treated with thiazolinediones for type 2 diabetes mellitus. Bone loss with fractures also occurs in patients treated with drugs targeting the immune system, such as calcineurin inhibitors, antiretroviral drugs, selective inhibitors of serotonin reuptake, anticonvulsants, loop diuretics, heparin, oral anticoagulants, and proton pump inhibitors.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Androgen Antagonists / adverse effects
  • Anti-Retroviral Agents / adverse effects
  • Aromatase Inhibitors / adverse effects
  • Bone Density / drug effects
  • Calcineurin Inhibitors
  • Female
  • Fractures, Bone / etiology
  • Glucocorticoids / adverse effects
  • Gonadotropin-Releasing Hormone / agonists
  • Humans
  • Male
  • Osteoporosis / chemically induced*
  • Thiazolidinediones / adverse effects
  • Thyroxine / adverse effects


  • Androgen Antagonists
  • Anti-Retroviral Agents
  • Aromatase Inhibitors
  • Calcineurin Inhibitors
  • Glucocorticoids
  • Thiazolidinediones
  • Gonadotropin-Releasing Hormone
  • Thyroxine