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Osteoporotic fractures are an important public health problem due to their negative impact on the quality of life and life expectancy, as well as high cost of treatment and rehabilitation. Along with the major risk factors for osteoporotic fractures, such as low bone mineral density (BMD), age, low body weight, frequent falls and previous fractures, an important secondary risk factor, especially among susceptible individuals, is taking certain medications. The difficulty in assessing fracture risk when taking various drugs, as well as the development of appropriate methods of prevention and treatment, is often due to the absence of large randomized trials with a sufficient level of evidence, as well as the heterogeneity of the main risk factors for fractures in studied groups of patients. We focus on the main groups of drugs for which there is evidence of a negative impact on bone metabolism, BMD and fracture risk. In addition to drugs, bone metabolism is also influenced by bariatric surgery, transplantation of solid organs, gonadectomy for various diseases.