Bisphosphonates

Question 1

What must be corrected prior to commencing bisphosphonate therapy?

Answer 1

Hypocalcaemia/ Vitamin D deficiency
Bisphosphonates inhibit osteoclastic activity to reduce bone loss. Normally when calcium levels fall, we rely on osteoclasts (via PTH + calcitriol) to increase our calcium levels.
Thus bisphosphate therapy impairs capacity to restore