8 Medications That Can Weaken Your Bones

Bone loss becomes more common as you age, and several drugs can contribute to the risk of osteoporosis.

8-minute read

Kimberly Goad and Michael Schroeder,

Updated September 29, 2026

AARP

Reviewed by

Zachary Cox, PharmD

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Updated September 29, 2026

illustration of a healthcare provider holding up two X-ray panels against a blue background. Instead of bones, the X-rays reveal a round pill and a capsule, both of which appear cracked or fractured.

Kyle Hilton

Key Takeaways

Some commonly used medications may contribute to bone loss and fractures.
Risk can rise with higher doses, prolonged use or certain older drugs.
Patients can ask about screening, alternatives and bone-protection strategies.

Getting older. A sedentary lifestyle. Low levels of calcium. All of these are well-known risk factors for osteoporosis, a condition that causes bones to weaken and becomes more common with age. But there’s another lesser-known one that belongs on the list: taking certain medications.

Research shows that some of the most commonly used drugs among people 50 and over can lead to what’s known as medication-induced osteoporosis and even an increased risk of fractures.

“Most patients and their health care providers are unaware of the additional fracture risks that common prescriptions can cause,” says Dr. Mary Beth Humphrey, a professor of medicine at the University of Oklahoma College of Medicine and a rheumatologist at OU Health in Oklahoma City. “With some of these medications, the longer a patient is on them, the higher the risk of fractures, [many of which] require one or more surgeries to hold the bones together and allow healing. Preventing these fractures should be a top priority for care providers and patients alike.”

Here’s a look at eight of the most common offenders.

1. Corticosteroids (a.k.a. glucocorticoids)

Oral corticosteroids — prescribed for everything from autoimmune diseases like lupus and rheumatoid arthritis to severe allergies, asthma and rashes — tamp down inflammation and reduce pain. But these medications (commonly referred to as steroids) come with an unfortunate side effect: They increase how quickly bone is broken down and interfere with the body’s ability to rebuild it. They also reduce the body’s ability to absorb calcium, all of which increases the risk of fractures and osteoporosis, making them one of the worst drugs for bone density and bone health. In fact, they are the most common cause of medication-induced osteoporosis, and doctors say they are especially problematic for older adults. Use of high doses and long durations of treatment are the greatest risks to bone health.

“Young people treated with [corticosteroids] may be able to fully recover their bone strength after the steroids are stopped,” Humphrey says. “However, people over 50 have lost the ability to recover bone strength without the aid of osteoporosis therapies.”

Corticosteroids include:

Prednisone 
Hydrocortisone
Methylprednisolone
Dexamethasone

What to do: If you’re on a high dose of an oral corticosteroid or you’ve been taking the medication for a long time — both of which make bone loss more likely — be sure your doctor regularly monitors your bone density to ensure it stays at a healthy level, suggests the American College of Rheumatology.

“It’s recommended to use the lowest effective dose for the shortest period,” Humphrey says. “If a patient is going to be on a dose of 5 milligrams or more for three or more months, it is recommended to start osteoporosis therapy to prevent bone loss.”

Humphrey also recommends talking to your doctor about whether you’re getting enough vitamin D and calcium; you may need supplements. Your provider may perform what’s known as a FRAX (fracture risk assessment tool) analysis or send you for a bone density test to determine if you’re at an increased risk for fracture.

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“Your age and your bone density tell the doctor what your risk of fracture is,” Humphrey says.

Patients should also take steps to maintain their bone health, adds Dr. Andrea Singer, director of bone densitometry at MedStar Georgetown University Hospital and chief medical officer of the Bone Health & Osteoporosis Foundation. That includes eating a well-rounded diet with enough protein and nutrients like calcium.

“Protein helps keep muscles strong,” Singer says. “If people have weaker muscles and they fall on weakened bones, they’re going to break something.”

She also recommends limiting alcohol, taking calcium and vitamin D supplements when needed and getting regular exercise.

An exercise routine should include more than aerobic activity, Singer says. It should also incorporate resistance training and balance exercises to help prevent falls and fractures.

2. Proton pump inhibitors (PPIs)

What does a common medication for heartburn have to do with bone health? In reducing stomach acid, PPIs may prevent the absorption of certain forms of calcium, so your body resorts to leaching calcium from your bones.

“The lower the bone density, the greater the fracture risk in general,” Singer says. Indeed, research shows a significantly higher risk of bone fractures in people who take PPIs compared with those who don’t.

Only PPIs available by prescription include a warning about the risk; not so with over-the-counter (OTC) versions. That’s likely because you aren’t supposed to take OTC PPIs for more than two weeks, which isn’t long enough to affect bone density.

PPIs include:

Omeprazole
Lansoprazole
Esomeprazole
Pantoprazole

What to do: The risk associated with PPIs is linked to long-term use. If you have chronic acid reflux, talk to your doctor about alternative treatments. Research shows, for instance, that lifestyle changes — like losing weight, quitting cigarettes and sleeping with your head elevated — can help manage symptoms.

3. Selective serotonin reuptake inhibitors (SSRIs)

The relationship between bone health and SSRIs — the most commonly prescribed class of antidepressants — is, well, complicated. While SSRIs increase serotonin in the brain, which can benefit bones, they may have the opposite effect on the vast majority of serotonin in the body, what’s known as peripheral serotonin, causing bone loss.

SSRIs include:

Fluoxetine (Prozac)
Paroxetine (Paxil)
Citalopram (Celexa)
Escitalopram (Lexapro)
Sertraline (Zoloft)

What to do: If you’re on an SSRI, talk to your health care provider about the potential effect of your particular antidepressant on your bone health. Depending on the severity of depression, sex, duration of use, length of SSRI treatment and other factors that can raise your risk of osteoporosis, you may be a good candidate for an alternative type of antidepressant or bone loss prevention strategies.

4. Anticonvulsant drugs

These medications are commonly used for treating seizures. They are also frequently prescribed for nerve damage, since the drugs calm overactive nerves to ease chronic pain and tingling.

In addition, the drugs — sometimes prescribed for migraines and mood disorders — can interfere with the way your body metabolizes vitamin D, a nutrient that has its own starring role in the health of your bones. If you aren’t getting enough vitamin D, your body can’t absorb calcium the way it should.

Anticonvulsant drugs that may weaken your bones include:

Carbamazepine (Tegretol)
Phenytoin (Dilantin)
Primidone (Mysoline)
Phenobarbital (Luminal, Solfoton)

What to do: Talk to your doctor about alternative medications since not all anticonvulsants carry the same increased risk of fracture. The older anticonvulsants are especially problematic for bone health, Singer notes, echoing research showing lower bone mineral density in patients on enzyme-inducing drugs (like those listed above) as compared with so-called noninducers.

5. Loop diuretics

These commonly prescribed water pills manage edema related to conditions like congestive heart failure and chronic kidney disease.

But a number of studies link loop diuretics to increased bone loss and an increased risk of fractures. Experts aren’t entirely sure why, but research suggests that because diuretics increase urination, they also promote calcium loss in the urine.

“When you increase calcium loss, that can affect parathyroid hormone,” potentially disrupting the usual process of bone remodeling, Singer says.  

Further complicating matters: Diuretics may also play a role in exacerbating orthostatic hypotension, a type of low blood pressure that creates dizziness when standing up, leading to an increased likelihood of falls and subsequent fractures. 

Diuretics that may weaken your bones include:

Furosemide (Lasix)
Bumetanide (Bumex)
Torsemide (Demadex)

What to do: “There may be some relationship between dose and duration of use, so longer-term use could potentially be problematic,” Singer says.

If you are required to take diuretics over the long term, talk to your doctor about using the lowest possible dose and monitoring bone health. If loop diuretics are used for high blood pressure, you can ask your doctor whether thiazide diuretics (Microzide, Esidrix) make sense for you. Research suggests that thiazides may have a positive effect on bone mineral density. 

6. Anticoagulants

Although the research is inconclusive, blood thinners (like warfarin) are believed to increase the risk of osteoporosis because they block vitamin K, which is crucial for bone health.

What to do: Not all anticoagulants pose the same potential risk for fractures, and the risk becomes more of an issue with prolonged use.

Depending on your overall health and the condition you’re treating, you may be able to switch to one of the blood thinners known as direct oral anticoagulants (DOACs). DOACs — such as apixaban (Eliquis), dabigatran (Pradaxa), rivaroxaban (Xarelto) and edoxaban (Savaysa) — don’t carry the same risk for osteoporosis as heparin and warfarin, but they may not be right for everyone. Your doctor can explain the risks and benefits.

7. Immunosuppressant medications

While not as widely used as other bone-weakening medications, like corticosteroids, immunosuppressant medications can also affect the bones.

The medications are used extensively in organ transplant patients, including people who have had heart, kidney or lung transplants, Humphrey says. They’re also used to treat autoimmune diseases such as dermatomyositis, interstitial lung disease and, in some cases, lupus.

“These drugs are very good at suppressing the immune system, but they also add a significant risk of fracture,” Humphrey adds.

Immunosuppressant medications that raise fracture risk include:

Cyclosporine
Tacrolimus

What to do: Immunosuppressant drugs can be literal lifesavers, so simply stopping them to avoid fracture risk may not be feasible. Instead, Humphrey says, patients’ bone health should be monitored closely. “Then we’ll put them on medication to prevent the bone loss or to help them build back bone,” she says.

8. Antiretroviral drugs for HIV

Antiretroviral drugs have “changed the face of HIV,” Singer says. Instead of the diagnosis being a death sentence, this drug therapy has turned the virus that attacks the body’s immune system into a chronic disease. “People live for decades with HIV,” she says.

About 1.1 million people, including nearly 600,000 individuals who are 50 or older, live with diagnosed HIV, according to data from the Centers for Disease Control and Prevention. But these medications can have side effects, including bone loss.

Antiretrovirals that can weaken bones include:

Tenofovir disoproxil fumarate (Viread and multiple combination tablets)
Protease inhibitors (such as atazanavir)

What to do: Because the drugs help keep people with HIV alive, the risk of bone loss doesn’t prevent them from being prescribed. “However, it should alert the clinician to screen for risk,” Singer says. That could include ordering a FRAX analysis or a bone density test.

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The key takeaways were created with the assistance of generative AI. An AARP editor reviewed and refined the content for accuracy and clarity.

Editor's Note: This story, originally published in January 2026, has been updated to include new information.

Kimberly Goad is a New York-based journalist who has covered health for some of the nation’s top consumer publications. Her work has appeared in Women’s Health, Prevention, Health and Reader's Digest.

Michael Schroeder is a freelance health writer and editor who's covered everything from chronic disease and mental health to medication side effects. His stories have been published in a range of print and digital publications, including Time, U.S. News & World Report, The Washington Post, and Psychology Today.

Zachary Cox is a pharmacist and professor at Lipscomb University College of Pharmacy and adjunct professor at Vanderbilt University School of Medicine in Nashville, Tennessee.