Reclast

Increased risk of renal impairment: pre-existing renal compromise, advanced age, concomitant nephrotoxic drugs or diuretics, or severe dehydration. Chronic renal impairment. Monitor creatinine clearance before each dose and in at-risk patients. Correct preexisting hypocalcemia, other mineral or bone disturbances before starting. Do baseline oral exam and preventive dentistry if risks for jaw osteonecrosis exist (eg, cancer, chemotherapy, angiogenesis inhibitors, radiotherapy, corticosteroids, poor oral hygiene, pre-existing dental disease or infection, anemia, coagulopathy). Ensure adequate hydration, Vit.D and calcium intake. History of bisphosphonate exposure: evaluate for atypical fractures if thigh/groin pain develops; consider withholding therapy until risk/benefit assessment. Aspirin-sensitive asthma. Avoid dental surgery (do preventative dental work before therapy). Reevaluate periodically. Elderly. Pregnancy: avoid use. Nursing mothers.