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Osteoporosis - preventing steroid-induced - Management
How should I reduce the risk of osteoporosis in people on corticosteroids?
- Give advice on calcium and vitamin D intake, exercise, smoking cessation, and alcohol consumption.
- Ensure that the person is taking the minimum dose of corticosteroid possible, and consider whether the corticosteroid could be administered by an alternative route (for example, topical or inhaled).
- Offer drug treatment to prevent osteoporosis in those people who have been taking oral corticosteroids for more than 3 months, or who are likely to do so, and who are:
- 65 years of age or more, or less than 65 years of age with a previous fragility fracture.
- Less than 65 years of age without a previous fragility fracture and a T-score of –1.5 or less.
- Consider starting treatment if there is a long wait for dual energy X-ray absorptiometry (DXA) scanning.
- If drug treatment is not indicated because the T-score is between 0 and –1.5, repeat the DXA scan in 1 to 3 years if corticosteroid use continues.
- Refer premenopausal women and men who are found to have osteoporosis to a specialist for further investigation and management.
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