Discontinue use if dysphagia, odynophagia, retrosternal pain, new or worsening heartburn develops. Local irritation of upper GI mucosa. Active upper GI problems eg, dysphagia, esophageal diseases, gastritis, duodenitis or ulcers. Osteonecrosis of the jaw & external auditory canal; invasive dental surgery; bone, join &/or muscle pain. Evaluate stress fractures, known causes & risk factors eg, vit D deficiency, malabsorption, glucocorticoid use, previous stress fracture, low extremity arthritis or fracture, extreme or increased exercise, DM, chronic alcohol abuse. Correct hypocalcaemia & other disorders affecting mineral absorption (eg, vit D deficiency) prior to therapy. Monitor serum Ca, phosphate & urine. Not recommended in severe renal insufficiency (CrCl <35 mL/min). Not to be given during pregnancy & lactation. Not to be given to childn.