May cause local irritation of the upper GI mucosa. Discontinue use if dysphagia, odynophagia, retrosternal pain or new or worsening heartburn occur. Active upper GI problems eg dysphagia, esophageal diseases, gastritis, duodenitis or ulcers. Consider causes of osteoporosis other than estrogen deficiency, aging & glucocorticoid use. Patients who develop osteonecrosis of the jaw should receive appropriate antibiotic therapy &/or oral surgery. Avoid invasive dental procedures in patients w/ cancer & those on chemotherapy, head & neck radiotherapy, corticosteroids or w/ poor oral hygiene. Monitor for atypical, low-energy or low trauma fractures of the femoral shaff. Correct hypocalcemia & other disorders affecting mineral metabolism (eg, vit D deficiency) prior to therapy.
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