Considerations regarding osteoporosis medications
| Oral bisphosphonates |
| Preferred because of safety, low cost, and lack of evidence of superior antifracture benefits from other osteoporosis medications |
| Avoid in patients with gastroesophageal reflux disease or esophagitis |
| Intravenous bisphosphonates |
| Higher risk with intravenous infusion (than with oral bisphosphonate therapy) of hypersensitivity reaction, acute-phase reaction (influenza-like illness), hypocalcemia |
| Longer half-life |
| Consider for better adherence, given no weekly pill burden |
| Teriparatide |
| Expensive; burden of therapy with daily injections |
| Limited to 2 years of therapy |
| Caution in patients with urolithiasis |
| Denosumab |
| Lack of safety data in premenopausal women |
| Hypersensitivity reaction, infection risk |
Based on information in reference 9.