BONFIT

*Treatment of postmenopausal osteoporosis:* Adult (female): 10 mg daily, alternatively 70 mg once weekly. The tablet should be taken upon arising with a full glass of water, 30 min before food, drink or other oral medications. Remain upright for 30 min after dose. *Treatment of osteoporosis in men:* Adult (male): 10 mg daily. The tablet should be taken upon arising with a full glass of water, 30 min before food, drink or other oral medications. Remain upright for 30 min after dose. *Prevention and treatment of corticosteroid-induced osteoporosis in postmenopausal women not receiving hormone replacement therapy:* Adult (female): 10 mg daily. The tablet should be taken upon arising with a full glass of water, 30 min before food, drink or other oral medications. Remain upright for 30 min after dose.

Renal impairment with GFR <35 ml/min, oesophageal abnormalities, stricture, achalasia or inability to remain upright for 30 min after dosing, hypocalcaemia.

Active GI bleeding, atypical femoral fractures, duodenitis, dysphagia, exclude other causes of osteoporosis, gastritis, history (within 1 year) of ulcers, surgery of the upper gastro-intestinal tract, symptomatic oesophageal disease, ulcers, upper GI disorders. Treat hypocalcaemia or vitamin D deficiency first. Warn patient to report any symp-toms such as difficulty in swallowing, retrosternal pain or worsening heartburn, and to discontinue immediately.

Calcium supplement, antacids, NSAID.

Abdominal distension and pain, constipation, diarrhoea, dyspepsia, flatulence, headache, oesophageal reactions (oesophagitis, oesophageal ulcers, oesophageal stricture and oesophageal erosions), regurgitation, musculoskeletal pain, episcleritis, erythema, gastritis, nausea, rash, scleritis, uveitis, vomiting. Rare: Atypical femoral fractures with long-term use, hypocalcaemia, osteonecrosis of the jaw, photosensitivity, severe skin reactions, Stevens-Johnson syndrome, toxic epidermal necrolysis, upper gastro-intestinal ulcers