Avoid intake at the same time w/ food, drinks & medicinal products containing polyvalent cations (eg, Ca, Mg, Fe & Al). High age or clinical risk factors for fracture. Patients w/ history of oesophageal disorders eg, stricture or achalasia; unable to stay in the upright position for at least 30 min after taking the tab; active or recent oesophageal or upper GI problems. Monitor patients who develop symptoms of esophageal irritation. Hypocalcemia & other disturbances of bone & mineral metabolism ie, parathyroid dysfunction, hypovitaminosis D should be treated before starting or at the time of starting therapy. Osteonecrosis of the jaw has been reported. Patients w/ rare hereditary problems of galactose intolerance & Lapp lactase deficiency or glucose malabsorption. Consider dental exam w/ appropriate preventive dentistry prior to treatment in patients w/ concomitant risk factors (eg, cancer chemotherapy, radiotherapy, corticosteroids, poor oral hygiene). Do not use during pregnancy & lactation. Elderly >80 yr.
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