For age related osteoporosis: age >= 50 years
For postmenopausal osteoporosis: post-menopausal state
Indications - one or more of the following:
(1) history of a hip and/or vertebral fracture
(2) DEXA scan T score <= -2.5 at vertebra or hip
(3) osteopenia with 10 year probability of a femoral fracture >= 3%
(4) osteopenia with a 10 year probability of a major fracture (multiple sites) >= 20%
(5) patient desire for therapy and likelihood of benefit > risk from therapy
where:
• Osteopenia or low bone mass is seen with a T score in the range of -2.49 to -1.0.
Drug therapy should be done in conjunction with:
(1) lifestyle changes
(2) modification of medications and other correctable factors affecting bone density
(3) therapy of co-existent osteomalacia
(4) reduction of fall risk
