Discontinue use if dysphagia, odynophagia, retrosternal pain, new or worsening heartburn develops. Active upper GI problems (eg, Barrett's esophagus, dysphagia, other esophageal diseases, gastritis, duodenitis or ulcers). Osteonecrosis of the jaw & external auditory canal; cancer diagnosis, co-morbid disorders eg, anemia, coagulopathy, infection, pre-existing dental disease; dental surgery; infection or trauma; chronic ear infections. Treat hypocalcemia & other bone & mineral metabolism disturbances prior to treatment. Ensure adequate intake of Ca or vit D. Concomitant use w/ NSAIDs; chemotherapy including angiogenesis inhibitors, RT, corticosteroids. Severe renal impairment (CrCl <30 mL/min). Not to be used during pregnancy & lactation. Childn <18 yr.
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