Hypersensitivity. Discontinue treatment if anaphylactic or allergic reactions, MI or stroke, osteonecrosis occur. Do not initiate in patients who have had MI or stroke w/in the preceding yr. Correct hypocalcemia prior to treatment. Monitor patients for signs & symptoms of hypocalcemia; serum Ca in patients w/ severe renal treatment (estimated GFR 15-29 mL/min/1.73 m
2) or receiving dialysis. Adequately supplement patients w/ Ca & vit D during treatment. Perform routine oral exam prior to initiation of treatment. Concomitant use w/ drugs associated w/ osteonecrosis of the jaw (eg, chemotherapy, bisphosphonates, denosumab, angiogenesis inhibitors & corticosteroids). Patients requiring invasive dental procedures. Evaluate patient who presents w/ thigh or groin pain suspected of having atypical fracture. Assess patients presenting w/ an atypical femur fracture for fracture in the contralateral limb. Not indicated for women of reproductive potential. Pregnancy & lactation. Ped patients & elderly.