Do not repeat DEXA more than every 1-2 years.
- Common supplementation dose: 1000-1200 mg/d
- Calcium carbonate can be dispensed in 500 mg and 600 mg increments.
- If not taking a PPI:
- If taking a PPI (for better absorption):
- Calcium citrate (dispensed in 300 mg increments)
- Common supplementation dose: 800-2000 IU/d
- Take first thing in the morning, prior to breakfast.
- Do not take Calcium or Vitamin D for at least one hour after taking a bisphosphonate
- Generally avoided if CCr<35 mL/min
- Consider drug holiday every 3-5 years of treatment
- Alendronate (Fosamax)
- Prophylaxis: 5 mg/d or 35 mg/week
- Treatment: 10 mg/d or 70 mg/week