Division of Bone Diseases, Department of Medical Specialties, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
Expert Rev Clin Pharmacol. 2011 Sep;4(5):593-604. doi: 10.1586/ecp.11.42.
Treatments for postmenopausal osteoporosis are generally safe, but are linked to some rare serious adverse drug reactions, for which causality is not always certain. The bisphosphonates are associated with gastrointestinal effects, acute phase reactions, and musculoskeletal pain, and, more rarely, cases of atrial fibrillation, subtrochanteric fracture, osteonecrosis of the jaw, cutaneous hypersensitivity reactions and renal impairment. It is too soon for pharmacovigilance data on denosumab, but it has been associated with cutaneous effects and possibly osteonecrosis of the jaw (to date, only in metastatic cancer). The selective estrogen receptor modulators may induce hot flushes and leg cramps, and--more rarely--venous thromboembolism and stroke. Strontium ranelate is associated with headache, nausea and diarrhea, and, more rarely, cutaneous hypersensitivity reactions and venous thromboembolism, while teriparatide and parathyroid hormone(1-84) are associated with headache, nausea, dizziness and limb pain. The management of osteoporosis should entail weighing the probability of adverse reactions against the benefits of therapy--that is, reduction of fracture risk.
治疗绝经后骨质疏松症的方法通常是安全的，但与一些罕见的严重药物不良反应有关，这些不良反应的因果关系并不总是确定的。双膦酸盐与胃肠道作用、急性期反应和肌肉骨骼疼痛有关，更罕见的情况下与心房颤动、转子下骨折、下颌骨坏死、皮肤过敏反应和肾功能损害有关。关于地舒单抗的药物警戒数据还为时过早，但它与皮肤效应和可能的下颌骨坏死（迄今为止，仅在转移性癌症中）有关。选择性雌激素受体调节剂可能会引起热潮红和腿部痉挛，而且更罕见的情况下会引起静脉血栓栓塞和中风。雷奈酸锶与头痛、恶心和腹泻有关，更罕见的情况下会引起皮肤过敏反应和静脉血栓栓塞，而特立帕肽和甲状旁腺激素（1-84）与头痛、恶心、头晕和肢体疼痛有关。骨质疏松症的治疗应权衡不良反应的可能性与治疗的益处，即降低骨折风险。
