Coping

Remember: You can live well with osteoporosis!
Thought for today: A generation ago most people who finished a day’s work needed
rest. Now, they need exercise!
Questions and answers from the virtual forum:
There is this one more issue, following this one, which contains the questions asked by
participants of the virtual forum and the answers given by our specialists.
29. Q: Please talk about the interactions of calcium with other prescription drugs.

A: Because calcium can interfere with the absorption of other drugs, do not take
other medications within 1-2 hours of taking calcium, or as indicated on the
product monograph of the other medication. Tell your doctor about all
prescription and non-prescription drugs you may be using. Do not start or stop
any medicine without doctor or pharmacist approval. Interactions may occur with
the following:
Blood pressure medications -- study results are conflicting and controversial.
However, if you take a beta-blocker or calcium-channel blocker, do not take
calcium supplements without your doctor’s supervision.
Bisphosphonates for osteoporosis -- calcium interferes with the absorption of the
bisphosphonates (etidronate, alendronate, risedronate) and therefore calcium
should not be taken within 1/2 - 2 hours of these medications.
Digoxin -- high levels of calcium may increase the risk of a toxic reaction to
digoxin, a medication used to treat irregular heart rhythms. On the other hand,
low levels of calcium cause digoxin to be ineffective. If you take digoxin, your
doctor should monitor your calcium levels closely. It should be noted that your
blood calcium level is usually not affected at all by taking calcium supplements.
Antibiotics -- different types of antibiotics interact with calcium. Quinolones:
calcium can interfere with the body's ability to absorb quinolone antibiotics (such
as ciprofloxacin, levofloxacin, norfloxacin and ofloxacin). Take calcium
supplements 2 - 4 hours before or after taking quinolone antibiotics. Gentamicin:
taking calcium during treatment with the antibiotic gentamicin may increase the
potential for toxic effects on the kidneys. Tetracyclines: calcium can interfere
with the body's ability to absorb tetracycline antibiotics (including doxycycline,
minocycline, and tetracycline). Take calcium supplements 2 - 4 hours before or
after taking tetracycline antibiotics.
Anti-seizure medications, such as phenytoin (Dilantin), carbamazepine (Tegretol)
-- take doses of calcium and anti-seizure medications at least 2 hours apart,
because each interferes with the absorption of the other.
Iron and calcium -- these interfere with each other and should therefore be taken
at different times of the day, at least two hours apart.
Calcium carbonate should not be used with any condition where the blood
calcium tends to be high, such as an overactive parathyroid condition. Patients
on dialysis or with severe chronic kidney disease should consult their physician
before taking calcium supplements.
The best approach is to discuss your medications with your pharmacist to look at
any possibility of interaction between your medications, including calcium
supplementation.

30. Q: I’m wondering what people's experiences have been with the new once-a-
year injection medication, as I have stomach problems and am considering this
option.

A: Aclasta®, which is the once–a-year injectable medication for osteoporosis,
doesn’t cause any stomach problems. Potential side effects of Aclasta® include
bone, muscle or joint pain, flu-like symptoms, fever and headache, which usually
last only a day or two and typically occur only after the first dose.
31. Q: If I have already been diagnosed and am taking medication, how often
should I have a bone density test?

A: One of the reasons for having a bone mineral density test is to monitor the
effectiveness of treatment. Osteoporosis Canada recommends follow-up
measurements one to two years after starting therapy to ensure that rapid bone
loss is not continuing and to assess response to medication. If the person is not
losing bone mass, a second follow-up to assess therapy should be conducted in
a few years or if there is a change of medication.

32. Q: I am a 59-year-old female, diagnosed with osteoporosis about six years
ago. I took Actonel® for five years and have been off it for a year. My Medical
Services Plan does not allow for another bone density test until November 2009.
Is it OK to leave it until then?

A: Unfortunately, we cannot answer this question adequately because we do not
know what your prior bone mineral density (BMD) was, if you have ever had any
fractures, and when your last BMD test was.
Watch for the next issue of COPING for more answers to your questions.

Funny Bone: At the movies the other night the cops were on the screen and the
robbers were behind the refreshment counter.
Remember: It is important for you to eat a healthy diet, get some appropriate
exercise, take your calcium and vitamin D and if your doctor has prescribed a
medication don’t forget to take it as directed.
COPN Weekly will come to you every second Friday. We hope you enjoy it and find
the information useful. Don’t forget to log on tofor up to date
information. For telephone inquiries, please call 1-800-463-6842 or 416-696-2663.
The material contained in this newsletter is provided for general information only. It should not be relied on to suggest a course of treatment for a particular individual or as a substitute for consultation with qualified health professionals who are familiar with your individual medical needs. Should you have any health care related questions or concerns, you should contact your physician. You should never disregard medical advice or delay in seeking it because of something you have read in this or any newsletter.

Source: http://www.osteoporosis.ca/wp-content/uploads/COPING_June_12_2009.pdf