Discontinue use if anaphylactic or other clinically significant allergic reaction occurs. Hypocalcemia must be corrected prior to initiating therapy. Severe renal impairment (CrCl <30 mL/min); patients receiving dialysis. Adequate Ca & vit D supplementation. Osteonecrosis of the jaw & external auditory canal. Consider dental exam w/ preventive dentistry prior to treatment. Avoid invasive dental procedures & maintain good oral hygiene during treatment. Atypical femoral fractures. Multiple vertebral fractures (MVF) following discontinuation of treatment. Risk of developing serious infections. Consider discontinuation in case of severe dermatologic reactions; severe bone, joint &/or muscle pain. Suppression of bone remodeling. Lactation. Childn.