Table 2 Summary of drugs for osteoporosis treatment and their side effects

Bone basic nutrient supplements

Calcium

Calcium carbonate, calcium acetate

Hypercalcemia caused by overdose

Vitamin D

Vitamin D, 1αOH-VitD, 1,25OH-VitD

Hypercalcemia and vitamin D poisoning caused by overdose

Antiresorptive

Bisphosphonate

Alendronate, zoledronic acid, sodium risedronate, ibandronate, etidronate, chlorophosphonate

Gastrointestinal adverse reactions, transient influenza-like symptoms, nephrotoxicity, mandibular necrosis, atypical femoral fracture

Menopausal hormone

Estrogen, progesterone

Risk of estrogen-related diseases such as endometrial cancer, breast cancer, cardiovascular diseases, venous thrombosis, obesity

Selective estrogen receptor modulators, SERMs

Raloxifene

Not suitable for male patients with osteoporosis. The risk of venous thrombosis is lower than that with estrogen

Calcitonin

Elcatonin, salcatonin

Some cases of facial flushing, nausea, and allergy

Fully human RANKL monoclonal antibody

Denosumab

Hypocalcemia, infection (cystitis, upper respiratory tract infection, pneumonia, skin cellulitis, etc.), rash, skin pruritus, muscle or bone pain; long-term application may over-inhibit bone resorption, resulting in mandibular osteonecrosis or atypical femoral fracture

Cathepsin K inhibitor

Odanacatib

Cardiovascular events including atrial fibrillation and stroke risk

Anabolic

PTH analogues

Teriparatide acetate, abaloparatide

Short-term hypercalcemia, the treatment time should not exceed 24 months,

Anti-sclerotin monoclonal antibody

Romosozumab

Need further clinical data

Vitamin K

Menatetrenone

Stomach discomfort, contraindicated for patients taking warfarin

Bidirectional regulation

Strontium

Strontium ranelate

Venous thrombosis risk, adverse reactions of cardiovascular and cerebrovascular diseases