Medications as a risk factor for bone fracture

Abstract

Fracture risk increases substantially with age due to decreased bone density and muscle mass, and also problems with vision and balance. In the elderly, medication used to treat non-skeletal disorders is one of the causes of bone fracture accompanying decreased QOL. Increased fracture risk by medication is based on either adverse drug reactions on bone metabolism or adverse drug events such as falls. The use of fall risk-increasing drugs (FRIDs), such as opioids, dopaminergic agents, anxiolytics, antidepressants and hypnotics/sedatives, have been demonstrated to increase risk of fracture. Furthermore, in addition to FRIDs, many drugs have been found to affect bone mass and fracture risk as a result of the side effects on bone metabolism. The present article reviews the current understanding of several drugs influencing fracture risk. In particular, drugs affecting fracture risk through sympathetic neuronal activity are also discussed.