http://www.emedicinehealth.com

Women, for the most part are unfamiliar with the physiological changes that may result in osteoporosis in the post-menopausal years. Most women are unaware of their condition until they suffer their first painful fracture. Early awareness and intervention such as healthy diet and exercise can play a major role in preventing this silent disease, but there is much that can be done once the condition has been diagnosed.

Facts Every Woman Should Know

	Osteoporosis is a progressive condition of bone loss leading to increased risk of fractures and chronic bone pain.
	Osteoporosis generally affects women ages 65 to 84.
	Over the age of 65, almost 30 percent of women who are not taking some form of osteoporosis therapy preventive are classified as suffering from osteoporosis.
	Almost all women (93 percent) with osteoporosis were unaware of their condition when they were diagnosed.
	A recent National Institutes of Health (NIH) study reports that 90 percent of women don’t get the calcium needed for healthy bones in later years, however one in three households take some type of calcium supplement.

A Condition on the Rise

	Patient visits for osteoporosis have increased 132 percent since 1995.
	The number of women being treated for osteoporosis has grown 170 percent over the last three and a half years.
	At least 1.5 million bone fractures (wrist, vertebral, hip and rib) attributable to osteoporosis occur per year in the US. These fractures directly limit one's mobility and independence.

Women's Attitudes Toward Osteoporosis

	Seventy percent of women are not very familiar with the condition of osteoporosis.
	Roughly the same percentage of women (70%) who are at risk for osteoporosis do not take calcium supplements.
	Those women approaching menopause and those with more education are the most familiar with osteoporosis symptoms and treatment.

Recognizing the Symptoms

	Many osteoporosis sufferers are not aware of their condition until they experience a bone fracture.
	Repeated fractures may cause acute and chronic back pain, and may accompany a significant loss of height. In addition, both gastrointestinal and respiratory problems can occur as a result of the ribcage moving down to meet the pelvis.

Today's Treatment Options

	Hormone replacement therapy (HRT) has been associated with benefits such as increasing bone density. In spite of this, only 24 percent of women who are candidates for HRT received therapy.
	Calcium supplements are the second most popular product for osteoporosis treatment and prevention.
	A well-balanced calcium-rich diet, active lifestyle including weight-bearing exercise, limited caffeine and alcohol consumption and not smoking will all help to reduce the risk of osteoporosis.
	Other currently available treatment options for osteoporosis are limited by their increased incidence of gastrointestinal side effects and hot flashes.

Current Treatments in Osteoporosis:

• BONIVA



• FORTEO

	BONIVA is a prescription medicine used to treat or prevent osteoporosis in women after menopause.
	BONIVA may reverse bone loss by stopping more loss of bone and increasing bone mass in most women who take it, even though they won't be able to see or feel a difference. BONIVA may help lower the chances of breaking bones (fractures).
	For BONIVA to treat or prevent osteoporosis, you have to take it as prescribed. BONIVA will not work if you stop taking it.
Why BONIVA?
	Because you only need to take BONIVA once a month, there are interruptions to your morning routine and to your normal activities only once a month. As directed by your healthcare provider, just pick a day of the month that's easy for you to remember and take one BONIVA tablet once a month.
What is the most important information I should know about BONIVA?
	BONIVA may cause serious problems in the stomach and the esophagus (the tube that connects your mouth and stomach). These problems may include trouble swallowing, heartburn, and ulcers. You must take BONIVA exactly as prescribed for BONIVA to work for you and to lower the chance of serious side effects.
	Common side effects with BONIVA are diarrhea, pain in extremities (arms or legs), and dyspepsia (upset stomach).
	DO NOT take BONIVA if you: Have low blood calcium (hypocalcemia) Cannot sit or stand up for at least 1 hour (60 minutes) Have kidneys that work very poorly Are allergic to BONIVA or any of the other ingredients of BONIVA
How should BONIVA be taken?
	Take BONIVA as instructed by your healthcare provider. Take BONIVA first thing in the morning. Wait at least 1 hour (60 minutes) before eating or drinking anything except plain water. Swallow BONIVA whole (do not chew or suck) with at least 6 to 8 ounces (1 cup) of plain water. Do not take BONIVA with mineral water, sparkling water, coffee, tea, milk, or juice. Avoid taking any other oral medicine, including calcium, antacids, or vitamins. Avoid lying down for at least 60 minutes after taking BONIVA to help decrease the risk of stomach problems.
What Should I do if I Miss a Monthly Dose?
	If you do not take your BONIVA 150 mg tablet as scheduled, and your next BONIVA day is more than 7 days away, take BONIVA the next morning. Then continue taking BONIVA every month on your chosen day according to your original schedule.
	If you forget and your next scheduled BONIVA day is less than 7 days away, wait until your next scheduled BONIVA day to take your tablet.

FORTEO

	Parathyroid hormone is naturally produced as an 84-amino-acid polypeptide. There have been some studies with various forms of PTH. The FDA has recently (Dec 2002) approved recombinant PTH 1-34, with a new chemical name ofteriparatide made by Lilly with the brand name Forteo.
Dose
	The only dose is 20 mcg/day, given by intermittent subcutaneous injection once a day using a special injection device.
What is Forteo?
	Forteo is a man-made form of the naturally occurring hormone parathyroid. Forteo forms new bone, increases bone mineral density and bone strength, and as a result, reduces the chance of getting a broken bone.
	Forteo is used for men and women with osteoporosis who are at high risk for bone fractures.
	Forteo may also be used for purposes other than those listed here.
What Should I Discuss with my Healthcare Provider Before Using Forteo?
	Do not use Forteo without first talking to your doctor if you:  Have Paget's disease of the bone  Have unexplained high levels of alkaline phosphatase in the blood, which may indicate Paget's disease  Are a child or young adult  Have ever been diagnosed with bone cancer or other cancers that have spread (metastasized) to the bones  Have had Radiation Therapy involving the bone  Have a bone disease other than osteoporosis or  Have a high level of calcium in the blood (hypercalcemia)
	You may not be able to take Forteo, or you may require a dosage adjustment or special monitoring if you have any of the conditions listed above.
	Forteo is in the FDA pregnancy category C. This means that it is not known whether Forteo will be harmful to an unborn baby. Do not use Forteo without first talking to your doctor if you are pregnant or could become pregnant during treatment.
	It is not known whether Forteo passes into breast milk. Do not use Forteo without first talking to your doctor if you are breast-feeding a baby.
How Should I use Forteo?
	Use Forteo exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.
	Forteo is administered by injection using a prefilled delivery device. Your doctor or other healthcare provider will give you detailed instructions on how to inject the medication.
	Forteo is usually injected once a day into the thigh or abdomen (lower stomach area). Follow your doctor's instructions.
	Forteo can be injected at any time of the day. It may be easier to remember to use Forteo if it is used at about the same time each day.
	It is important to use Forteo regularly to get the most benefit.
	Forteo may cause dizziness or fast heartbeats after an injection. Inject the medication in a location where you can sit or lie down following the injection should dizziness or fast heartbeats occur.
	Use Forteo shortly after you take the pen out of the refrigerator. Recap the pen and put it back into the refrigerator right after use.
	The same pen can be used for up to 28 days after the first injection from the pen. Throw away the pen after 28 days of use, even if it is not completely empty.
	Do not use Forteo that is discolored or cloudy or that has particles in it. It should be clear and colorless. Do not use Forteo after the expiration date printed on the pen or pen packaging.
	Dispose of all needles and syringes in an appropriate, puncture-resistant disposal container.
	Your doctor may want to perform blood or urine tests during treatment to determine your response to Forteo.
	Store Forteo pens in the refrigerator at 36 to 46 degrees Fahrenheit (2 to 8 degrees Celsius). Do not freeze the medication. Do not use any medication that has been frozen.