Combining Certain Medications Compounds Risk of Bone Fractures, Study Finds

A new study appears to confirm the long-held suspicion that people, especially older individuals, who take multiple medications linked to bone fractures may face an exponentially increased risk of bone fractures. Suffering a bone fracture can be painful and debilitating, and for older individuals who may already have bones weakened by osteoporosis, taking a medication that carries a risk of bone fractures only makes the problem worse. Unfortunately, for those who have been diagnosed with certain diseases or medical conditions, taking a fracture-associated medication may be unavoidable. What can be avoided, however, is taking multiple fracture-associated drugs that, together, compound their risk of fractures. If you have suffered one or more bone fractures recently and you believe a prescription or over-the-counter medication to be the cause, contact an experienced product liability lawyer as soon as possible to find out if you may be eligible for compensation.

Increased Risk of Bone Fractures

For some time, medical experts have suspected that many older consumers are unknowingly compounding their fracture risk due to the wide variety of drugs routinely prescribed to elderly individuals that have been linked to bone fracture injuries. In a study published last week in the journal JAMA Network Open, researchers from Dartmouth University found that many older individuals who sustain bone fracture injuries do so while taking a “cocktail” of drugs that have the potential to weaken their bones. The cohort study looked at data involving more than 2.6 million Medicare beneficiaries from 2004 to 2014 and identified 21 different medications classified as “fracture-associated drugs” (FADs), including opioid drugs, proton pump inhibitors (PPIs) like Nexium and Prilosec, and diuretics.

According to the researchers’ findings, not only does taking multiple fracture-associated medications at once increase the risk of bone fractures, the fracture risk is compounded with each additional medication taken. For instance, while taking just one FAD doubled the risk of bone fractures among the patients reviewed as part of the study, taking two FADs nearly tripled the fracture risk and taking three or more quadrupled the risk. The researchers noted in the study that the most commonly used FADs were opioids, used by 55% of patients, followed by diuretics, used by 40% of patients, and PPIs, used by 35% of patients. According to the researchers, the drug combinations associated with the highest risk of bone fractures were opioids with other sedatives, opioids with diuretics, and opioids with PPIs.

FDA Issues Bone Fracture Warning

Bone fractures and bone density loss are serious concerns, especially for older individuals, and it is imperative that patients taking medications that can harm their bones are aware of the risk so they can monitor any potential issues and avoid debilitating injury. In 2010, the FDA required the makers of Nexium, Prilosec, Prevacid and other prescription and over-the-counter PPI drugs to update their warning labels to include the risk of bone fractures of the hip, spine and wrist associated with the use of proton pump inhibitors. The FDA’s decision came on the heels of several epidemiological studies reporting an increased risk of bone fractures associated with PPI use. One such study found that women who took proton pump inhibitors were 25% more likely to suffer a bone fracture over an eight-year period than women who did not take one of the drugs. There are many other types of drugs that have been linked to bone fracture side effects in recent years, including prednisone, certain medications prescribed to treat breast cancer, SSRI antidepressants and osteoporosis medications like Fosamax, Boniva and Reclast.

What Does this Mean for Consumers Taking Multiple FADs?

Among older individuals, fracture-associated drugs like opioids and PPIs are commonly used and commonly combined, which can be risky in terms of potential side effects. According to this recent JAMA Network Open study, “the addition of a second and third FAD was associated with a steep increase in fracture risk,” which is an important finding for individuals who routinely take multiple medications that are classified as fracture-associated drugs. The researchers also noted that many “risky pairs of FADs included potentially avoidable drugs,” like opioids and sedatives, and concluded that the compounded risk of bone fractures could be reduced through better adherence to prescribing guidelines and recommendations.