Bone loss leading to osteoporosis is common after the menopause and in the elderly but uncommon in normal young adults without
predisposing factors. The risk factors usually associated with osteoporosis include a family history of osteoporosis or fractures,
aging, prior diseases, sedentary lifestyle, low calcium intake, hypogonadism, vitamin D deficiency, smoking, and excessive
alcohol consumption. However, the issue of drugs has to be considered in “normal” individuals who present with osteoporosis
or bone loss without predisposing genetic or other environmental factors. The list of drugs is extensive and includes, amongst
others, glucocorticoids, thyroid hormone (excess), alcohol, medroxyprogesterone acetate, luteinizing hormone- releasing hormone
agonists, anti-seizure medications, cyclosporine A, aluminium, lithium, and exchange resins. This paper reviews the pathophysiology
and mechanisms of drug-induced bone loss, which includes osteoporosis and osteomalacia, and treatment concepts. Undoubtedly,
physician awareness, appropriate investigation, careful prescribing, monitoring, and proper therapy for this eminently preventable
side effect can preserve bone in the patients receiving bone-losing drugs.
Key words: Aluminium hydroxide – Antacids – Anticoagulants – Anticonvulsants – Antineoplastic agents – Antipsychotic agents
– Aromatase inhibitors – Bisphosphonates – Bone – Bone density – Cholestyramine – Cyclosporin A – Drugs induced – Etidronate
disodium – Ethanol – Fluorides – Fractures – Glucocorticoids – Gonadorelin – Iatrogenic disease – Immunosuppressive agents
– Levothyroxine – Lithium – Medroxyprogesterone – Methotrexate – Neuroleptics – Osteomalacia – Osteoporosis – Saccharated
ferric oxide