Steroids, Aromatase Inhibitors, and Other Drugs Associated with Osteoporosis

Several classes of medications may accelerate bone loss, thereby increasing the risk of low-trauma fractures in older or younger patients with normal bone density, osteopenia, or osteoporosis. Clinicians should be aware of these possible pharmacologic causes of bone loss in order to prevent fractures, especially in patients considered to be at very high risk due to recent fractures, propensity to falls, and/or comorbidities. Glucocorticoids, aromatase inhibitors, and many other drugs administered for a variety of chronic diseases are often noted to be taken during medical visits, in both inpatient and outpatient encounters. Medical personnel should always review the reconciled medications to safeguard the bone health of patients. This chapter focuses on the most common medications that cause osteoporosis, with attention to clinical aspects and management strategies in these situations.