Osteoporosis Treatment in Canada: Options and Drug Coverage
Last reviewed 2026-09-24
Osteoporosis makes bones thinner and more likely to break. In Canada, treatment decisions are based on your fracture risk (often estimated with the FRAX or CAROC tools) rather than bone density alone.
Foundations for everyone
- Regular exercise, including strength and balance training, to build bone and prevent falls.
- Enough calcium (mostly from food) and vitamin D — many Canadian adults need a vitamin D supplement, especially in winter.
- Stop smoking and limit alcohol.
- Fall-proof your home: lighting, grab bars, removing trip hazards.
Common medications
- Bisphosphonates: alendronate and risedronate (weekly pills), or zoledronic acid (yearly IV infusion). Usually first choice.
- Denosumab (Prolia): injection every 6 months. Doses shouldn't be delayed or stopped without a plan, because bone loss can rebound.
- Bone-building drugs for very high risk: teriparatide and romosozumab (Evenity).
- Raloxifene for some postmenopausal women.
Coverage
Generic alendronate and risedronate are covered by most provincial plans. Zoledronic acid, denosumab, teriparatide and romosozumab are often covered only with special authorization or Limited Use criteria (for example, after a fracture or if you can't take a bisphosphonate). Private plans vary. Check your provincial guide below.
Frequently asked questions
What is the first-line osteoporosis treatment in Canada?
For most people, a bisphosphonate such as alendronate or risedronate, together with exercise, calcium and vitamin D.
Is Prolia covered in Ontario?
Under the Ontario Drug Benefit it's generally a Limited Use drug — your prescriber must confirm you meet the criteria.
Official sources
This guide is general information, not medical or financial advice. Program rules and amounts change — confirm with the official source or your pharmacist.