Effectively treat hypocalcemia & other disturbances of bone & mineral metabolism before starting therapy. May cause upper GI disorders eg, dysphagia, esophagitis, esophageal ulcer, & gastric ulcer. Reports of osteonecrosis of the jaw (ONJ). Perform a routine oral examination prior to treatment. Perform routine dental check-ups & avoid invasive dental procedures while on treatment. Reports of atypical, low-energy, or low trauma fractures of the femoral shaft. Discontinue use in case of severe & occasionally incapacitating bone, joint, &/or muscle pain; ocular disturbances including conjunctivitis, uveitis, episcleritis, iritis, & scleritis. Not recommended for use in patients w/ severe renal impairment (CrCl <30 mL/min). Not intended for use during pregnancy & lactation.