Bone mineral density tx
Posted by dkwinter

Do not repeat DEXA more than every 1-2 years.

 

Calcium

  • Common supplementation dose: 1000-1200 mg/d
    • Calcium carbonate can be dispensed in 500 mg and 600 mg increments.
  • If not taking a PPI:
    • Calcium carbonate
  • If taking a PPI (for better absorption):
    • Calcium citrate (dispensed in 300 mg increments)

 

Vitamin D

  • Common supplementation dose: 800-2000 IU/d

 

Bisphosphonate

  • 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