If you have osteoporosis or are at risk for it, you should do everything possible to keep your bones strong. Besides following your doctor's advice on diet and exercise, it's important to know that some medications are bone-friendly while others may have side effects that affect bones. Some medications prescribed for common health issues like heartburn or depression can impact bone health. This doesn't mean you should stop taking them, but it's crucial to weigh the pros and cons. Doctors may prescribe a 'bone-maintenance' drug to offset the risk. Steroid drugs, for example, are used to treat conditions like rheumatoid arthritis, asthma, and ulcerative colitis, but they can reduce bone formation and increase bone resorption, raising fracture risk. Certain breast cancer patients take inhibitors that lower estrogen levels, which can be bad for bones; doctors often recommend lifestyle changes and bone-maintenance drugs. Prostate cancer treatments involving anti-androgen therapy can also affect bone density. Some antidepressants, like SSRIs, may impact bone health, although depression itself is linked to poor bone health. GERD patients may use proton pump inhibitors (PPIs), and long-term high doses may increase fracture risk. Diabetes drugs like thiazolidinediones have negative effects on bones. Bisphosphonates are used to treat osteoporosis but may cause rare thigh bone fractures with long-term use. Hormone replacement therapy (HRT) can help preserve bone but is generally not recommended due to risks like breast cancer, heart disease, and stroke.