Q. My doctor just prescribed Prevacid for acid reflux. I am reluctant to take this medicine because I have heard it might lead to weakened bones.

I already have severe osteoporosis because of a lengthy course of cortisone. This drug caused significant bone loss so I am now taking Fosamax. I would hate to undo the benefits I have gotten on Fosamax, but the drug does cause bad heartburn. I feel caught in a dilemma and would appreciate any information you might have.

A. A surprising number of medicines have a negative effect on bone density. Prednisone and similar steroid-type drugs are notorious for this, but even inhaled corticosteroids like those found in Advair or Flovent can have an impact. So can certain seizure medicines such as Dilantin, Klonopin or Tegretol as well as high-dose thyroid hormone (Levoxyl or Synthroid).

Acid suppressors such as Nexium, Prevacid, Prilosec or Protonix apparently reduce calcium absorption and may weaken bone as a result. Fosamax can cause irritation of the esophagus, but instead of taking a heartburn medicine, you might ask your doctor about a different osteoporosis drug.

We are sending you our Guide to Osteoporosis in which we discuss medications that contribute to weaker bones along with the pros and cons of a variety of medicines for this condition. 

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  1. D. Shue

    My daughter takes Prevacid for esophagitis, which was caused from a breathing tube. It’s a one-month course, but even that seems like for an already small person (40pounds). I’ve been giving her Vitamin D, 600-600 units daily. Would this counteract the drug’s negative side effect?

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