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Osteoporosis - preventing steroid-induced - Management
What drug treatment is recommended for the prevention or treatment of corticosteroid-induced osteoporosis?
- Prescribe a bisphosphonate (such as alendronate, risedronate, or cyclical etidronate).
- Once-daily alendronate and risedronate, and cyclical etidronate are licensed. Once-weekly alendronate and risedronate are an alternative but are not licensed for use in corticosteroid-induced osteoporosis.
- See Prescribing information on bisphosphonates.
- If a bisphosphonate is contraindicated, or is not tolerated, seek advice from a specialist regarding alternative treatments (for example alfacalcidol or calcitriol, or a zolendronic acid infusion).
- Hormone replacement therapy (HRT) is not recommended for women more than 50 years of age unless other treatments for osteoporosis cannot be taken. For information on HRT, see the CKS topic on Menopause.
- Prescribe calcium and vitamin D supplements with bisphosphonates if dietary intake is thought to be low.
- Check serum and urine calcium levels if hypocalcaemia or hypercalcaemia is suspected before or during treatment.
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