Osteoporosis, osteomalacia and epilepsy

Introduction

Osteoporosis (brittle bone disease) and osteomalacia (softening of the bones) are possible side-effects of some anti-epileptic drugs (AEDs). These drugs are carbamazepine, phenobarbital, phenytoin and sodium valproate.

It appears that these AEDs may reduce the body's vitamin D level, which can, in some cases, cause a loss of bone mass. Therefore, using these AEDs over a long period of time may be a risk factor for bone loss and fractures.

A bone density scan is advisable for people who have been taking the above AEDs long term, especially in people who are already at risk of osteoporosis or osteomalacia. This may include women who are going through the menopause and both men and women in later life.

Requesting a bone density scan in the UK

If you are concerned that you could be at risk of developing osteoporosis or osteomalacia, you may wish to discuss it with your doctor. They will probably look at your medical history and any drugs you are taking now, or have taken in the past, to assess the level of risk.

If your doctor thinks you are at risk of developing osteoporosis or osteomalacia, they can refer you to hospital for a bone density scan. However, it is worth bearing in mind that in some parts of the UK there is only limited access to bone density scans. Because of this your doctor may be reluctant to refer you unless they consider you are in a particularly high risk group.

It is possible to have a bone density scan done privately rather than on the NHS, if a scanner is available in your area. You could talk to your doctor about arranging a referral for you.

Report suspected side-effects of your medication

Epilepsy Action is encouraging UK residents who have been diagnosed with osteoporosis (brittle bone disease) or osteomalacia (softening of the bones), and suspect that this is a result of taking anti-epileptic medication, to report this to the Medicines and Healthcare products Regulatory Agency (MHRA).

Patients can directly report any suspected side-effects of taking medication to the MHRA through the Yellow Card Scheme. Yellow Cards are forms that can be completed to give details about medicines which are suspected to have negative side- effects. MHRA records all Yellow Cards they receive and takes appropriate action if it is found that there is a problem with a medicine.

You can report suspected side-effects on the MHRA website or by phoning the Yellow Card hotline, freephone: 0808 100 3352. Yellow Cards are also available in pharmacies, doctors' surgeries and other NHS outlets across the UK. If you would like help with completing the form, you can ask your doctor, pharmacist or any health care professional.

MHRA is a government agency which monitors the use of medicines and medical devices in the UK to ensure that they are acceptably safe.

Where can I obtain more information?

National Osteoporosis Society,
Camerton,
Bath
BA2 0PJ,
tel: 01761 471 771 (general enquiries),
Fax: 01761 471 104,
Helpline: 0845 4500 230 (medical enquiries),
Email: info@nos.org.uk
For a free pack phone 0800 0566 820 (freephone).

Related Links

• Epilepsy Action research into osteoporosis/osteomalacia - Summary of findings.
• Menopause

Information updated February 2008