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Class: Bone Resorption Inhibitors
- Bone Resorption Inhibitors
VA Class: HS900
CAS Number: 7414-83-7

Medically reviewed by Last updated on March 2, 2020.


Synthetic bisphosphonate; bone resorption inhibitor.c

Uses for Etidronate

Paget Disease of Bone

Used in the treatment of moderate to severe symptomatic Paget disease of bone (osteitis deformans).125 131 132 141 142 143 144 145 146

Efficacy not established in asymptomatic patients.125 May consider prophylactic treatment in patients with extensive involvement of the skull or spinal column and the possibility of irreversible neurologic damage or in those with extensive involvement threatening major joints or weight-bearing bones.125

Less effective than risedronate or alendronate in the treatment of moderate to severe Paget disease of bone.129 c

Relapse generally tends to occur within about 3–24 months in patients most likely to relapse (e.g., higher pretreatment markers of bone turnover).c

Resistance is most likely to develop in patients receiving >1 course of therapy per year or those with higher pretreatment indices of bone turnover.107

Heterotopic Ossification

Used in the prevention and treatment of heterotopic ossification (myositis ossificans, ectopic calcification, periarticular ossification, or paraosteoarthropathy) following total hip arthroplasty or resulting from spinal cord injury.125

Efficacy not established for treatment of idiopathic heterotopic ossification or heterotopic ossification associated with conditions other than total hip arthroplasty or spinal cord injury.c

Glucocorticoid-induced Osteoporosis

Bisphosphonates, including etidronate, have been used effectively for the prevention and treatment of glucocorticoid-induced osteoporosis.131 132 133 134 135 136 137 139 141 142 143 144 145 146 622

Etidronate Dosage and Administration


Paget Disease of Bone

  • Monitor patients for recurrence of disease every 3–6 months.125 Consider retreatment only after a drug-free interval of ≥90 days following the previous course of therapy if biochemical, symptomatic, or other evidence of recurrence is present.125

Heterotopic Ossification

  • Initiate therapy as soon as it is feasible following spinal cord injury and preferably before any radiographic evidence of heterotopic ossification.125 Efficacy of retreatment has not been established in these patients nor in patients undergoing total hip arthroplasty.125


Oral Administration

Administer as a single daily dose with a full glass (180–240 mL) of plain water to facilitate absorption; may divide dosage if adverse GI effects occur.125

Avoid lying down following oral administration.125

Avoid food, especially calcium-rich food (e.g., milk or milk products), vitamins with mineral supplements, or antacids that contain metals such as calcium, iron, magnesium, or aluminum for 2 hours before and after administration.125 (See Food under Pharmacokinetics.)


Available as etidronate disodium; dosage expressed in terms of the salt.125


Paget Disease of Bone

Initially, 5–10 mg/kg daily for ≤6 months, or 11–20 mg/kg daily for ≤3 months, have been used.125 Recommended initial dosage is 5 mg/kg daily for ≤6 months.125

Onset of therapeutic response may be delayed,125 and therapeutic effects may persist for months following a course of therapy.125 (See Onset under Pharmacokinetics.) Avoid premature increases in dosage125 since increased dosage may cause mineralization defects.125 c

Patients who require immediate suppression of Paget disease or in whom lower dosages are ineffective: >10 mg/kg daily for ≤3 months.125 Use with caution.c

Dosages >20 mg/kg daily not recommended.125

Retreatment: Dosage usually the same as initial treatment.125 Consider increasing dosage within the recommended range if inadequate response with original dosage.125 (See General: Paget Disease of Bone under Dosage and Administration.)

Heterotopic Ossification
Prevention and Treatment

Spinal cord injury: Initially, 20 mg/kg daily for 2 weeks followed by 10 mg/kg daily for an additional 10 weeks (12 weeks total).125

Total hip arthroplasty: Initially, 20 mg/kg daily administered preoperatively for 1 month and postoperatively for an additional 3 months (4 months total).125

Glucocorticoid-Induced Osteoporosis†
Prevention and Treatment

400 mg daily for 2 weeks every 3 months has been used, usually in conjunction with calcium (e.g., 500 mg daily) and vitamin D supplementation during the remaining 10–11 weeks of each cycle or continuously.141 142 143 144 145 146 147

Prescribing Limits


Paget Disease of Bone

Maximum 20 mg/kg daily.125

Treatment duration: ≤6 months; continuous therapy for >6 months may increase the risk of fracture and osteomalacia.125

Special Populations

Renal Impairment

Reduce dosage in patients with reduced glomerular filtration; monitor such patients closely.125

Geriatric Patients

Select dosage with caution because of age-related decreases in hepatic, renal, and/or cardiac function and concomitant disease and drug therapy.125

Cautions for Etidronate


  • Esophageal abnormalities that delay esophageal emptying (e.g., stricture, achalasia).125

  • Known hypersensitivity to etidronate disodium.125



Upper GI Effects

Possible severe adverse esophageal effects (e.g., esophagitis, esophageal ulcers, erosions, strictures, perforation).125 (See Oral Administration under Dosage and Administration.) Monitor for any manifestations and discontinue if dysphagia, odynophagia, new or worsening heartburn, or retrosternal pain occurs.125

Risk of severe adverse esophageal effects greater in patients who do not drink 180–240 mL of water with etidronate, do not avoid lying down for ≥30 minutes following oral administration, and/or continue to take drug after developing symptoms suggesting esophageal irritation.125 Instruct patients carefully about proper administration and give copy of patient instructions provided by the manufacturer.125

Use with caution in patients with history of upper GI disease (e.g., Barrett’s esophagus, dysphagia, other esophageal diseases, gastritis, duodenitis, ulcers).125 Gastric and duodenal ulcers (some severe and with complications) reported during postmarketing experience.125

General Precautions

Metabolic Effects

Maintain an adequate intake of calcium and vitamin D during therapy.125

Hyperphosphatemia may occur, especially with dosages of 10–20 mg/kg daily.125 (See Actions.) Usually returns to pretreatment values 2–4 weeks after treatment discontinuance.125


Therapy has been withheld in some patients with enterocolitis since diarrhea may occur, especially with high dosages.125

Osteonecrosis of the Jaw

Osteonecrosis and osteomyelitis of the jaw reported, principally in cancer patients receiving bisphosphonates, usually when given IV.125 147 148 149 150 151 Mostly associated with tooth extraction and/or local infection with delayed healing, but some cases occurred in patients with postmenopausal osteoporosis receiving oral therapy.125 Known risk factors include cancer, concomitant therapies (e.g., chemotherapy, corticosteroids, angiogenesis inhibitors), poor oral hygiene, preexisting dental disease, anemia, coagulopathy, and infection.125

If osteonecrosis of the jaw develops, consult an oral surgeon for treatment.125 Dental surgery may exacerbate condition.125

In patients requiring dental procedures, discontinuance of therapy prior to procedure may reduce the risk of osteonecrosis of the jaw.125 Base management of patients requiring dental treatment on an individual assessment of risks and benefits.125

Musculoskeletal Effects

Impairs mineralization of new osteoid, principally in pagetic lesions and to a lesser extent in normal bone at dosages of 10–20 mg/kg daily.125 c Also may delay mineralization of ectopic bone.c Mineralization occurs normally following completion of therapy.125

Long bones affected mainly by lytic pagetic lesions, particularly in patients whose disease is unresponsive to therapy, may be especially prone to fractures.125 Monitor patients with predominantly lytic lesions closely, both radiographically and biochemically, to permit timely discontinuance of therapy in those whose disease is unresponsive.125 If fractures occur, may be advisable to delay or withhold therapy until callus is evident.125

Severe and occasionally incapacitating bone, joint, and/or muscle pain reported infrequently with bisphosphonate therapy.125 148 153 154 Time to onset varied from 1 day to years (mean onset about 3 months) after treatment initiation.125 148 153 154 Such pain generally improves following discontinuance, but may recur upon subsequent rechallenge with the same drug or another bisphosphonate.125 148 153 154

Atrial Fibrillation

Although data are conflicting, possible increased risk of atrial fibrillation with use of bisphosphonates.155 FDA analysis of data from long-term (6 months to 3 years) controlled trials identified a higher rate of atrial fibrillation in patients receiving bisphosphonates (alendronate, ibandronate, risedronate, or zoledronic acid) versus placebo; however, only a few events reported in each study.155 FDA is continuing to monitor this safety concern.155

Potential Risk of Esophageal Cancer

Some evidence (from postmarketing experience and observational studies) suggests a possible association between use of oral bisphosphonates and an increased risk of esophageal cancer.156 160 161 However, because of conflicting data,161 162 163 additional study needed to confirm such findings.160

FDA states that benefits of oral bisphosphonates continue to outweigh their potential risks in patients with osteoporosis; it is important to consider that esophageal cancer is rare, especially in women.160 161

Avoidance of oral bisphosphonates in patients with Barrett’s esophagus, a known precursor to esophageal adenocarcinoma, has been recommended.156

Specific Populations


Category C.125


Not known whether etidronate is distributed into milk.125 Use with caution.125

Pediatric Use

Safety and efficacy in children not established.125 Has been used in children for the prevention of heterotopic ossification or soft tissue calcification at weight-adjusted dosages recommended for adults.125

Rachitic syndrome reported infrequently in children receiving dosages of ≥10 mg/kg daily for approximately 1 year or longer.125 Epiphyseal radiographic changes associated with retarded mineralization of new osteoid and cartilage and associated occasional symptoms were reversible following discontinuance of the drug.125

Geriatric Use

Insufficient experience in patients ≥65 years of age to determine whether geriatric patients respond differently than younger adults; select dosage with caution.125 (See Geriatric Patients under Dosage and Administration.)

Possible age-related impaired renal function and risk of toxic reactions; use with care.125 (See Renal Impairment under Cautions and under Dosage and Administration.)

Renal Impairment

Monitor patients with impaired renal function carefully.100 125 (See Renal Impairment under Dosage and Administration.)

Common Adverse Effects

Paget disease of bone: Bone pain, diarrhea, nausea.125

Heterotopic ossification: Diarrhea, nausea.125

Interactions for Etidronate

Specific Drugs





Increases in PT, mostly without clinically important sequelae125

Monitor PT when etidronate added to therapy125

Etidronate Pharmacokinetics



Approximately 3% of a dose is absorbed.125


Paget disease of bone: Reduced urinary excretion of hydroxyproline occurs after 1–3 months of therapy.c Reductions in markers of bone turnover reach a plateau in about 6 months.c


Paget disease of bone: May persist for ≥1 year following discontinuance of therapy.125 In patients whose disease is most likely to relapse, relapse generally tends to occur within about 3–24 months.c

Heterotopic ossification: Persists for ≥9 months following drug discontinuance.125


Food decreases extent of absorption.c



Following oral administration, about 50% of absorbed drug distributed almost exclusively into bone.125 c Eliminated slowly (weeks to years) via bone turnover.100 101 106 125

Drug does not cross blood-brain barrier in animals.125

Not known whether etidronate is distributed into milk.125



No evidence of metabolism.125

Elimination Route

Excreted unchanged in urine (approximately half of an absorbed dose)101 within 24 hours.125 Unabsorbed drug is excreted intact in feces.125


Plasma elimination half-life is 1–6 hours.125 Terminal half-life estimated to be 394 days.173





25°C (may be exposed to 15–30°C).125


  • Adsorbs to hydroxyapatite crystals and their amorphous precursors in bone matrix and inhibits their aggregation, growth, mineralization, and dissolution.125

  • Heterotopic ossification: Prevents or slows the formation of heterotopic bone during the active stage.125

  • Paget disease of bone: Reduces the number of osteoclasts and osteoblasts.125

  • Paget disease of bone: Reduces rate of bone turnover as evidenced by decreases in markers of bone turnover and reduced radionuclide uptake at pagetic lesions.125 c

  • Paget disease of bone: Reduces vascularity of pagetic bone, skin temperature over superficially located pagetic lesions, and cardiac output.125 c

  • Can increase serum phosphate concentration by increasing renal tubular reabsorption of phosphate.125 c

  • No immunosuppressive activity in animal studies.104

Advice to Patients

  • Importance of proper administration (e.g., avoiding food, vitamins with mineral supplements, or antacids that contain metals for 2 hours before and after administration).125

  • Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs and dietary or herbal supplements, as well as any concomitant illnesses.125

  • Importance of women informing their clinician if they are or plan to become pregnant or plan to breast-feed.125

  • Importance of informing patients of other important precautionary information.125 (See Cautions.)


Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name

Etidronate Disodium


Dosage Forms


Brand Names




200 mg*

Etidronate Disodium Tablets

400 mg*

Etidronate Disodium Tablets

AHFS DI Essentials™. © Copyright 2021, Selected Revisions March 12, 2018. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.

† Use is not currently included in the labeling approved by the US Food and Drug Administration.


Only references cited for selected revisions after 1984 are available electronically.

100. MGI Pharma. Didronel I.V. Infusion (etidronate disodium) prescribing information. Minnetonka, MN; 1998 Jan.

101. Norwich Eaton Pharmaceuticals, Inc. Didronel I.V. Infusion (etidronate disodium) background data for review by pharmacy and therapeutic committees. Publication No. 2326-70. Norwich, NY; 1987 Apr.

102. Kanis JA, Urwin GH, Gray RES et al. Effects of intravenous etidronate disodium on skeletal and calcium metabolism. Am J Med. 1987; 82(Suppl 2A):55-70.

103. Guaitani A, Polentarutti N, Filippeschi S et al. Effects of disodium etidronate in murine tumor models. Eur J Cancer Clin Oncol. 1984; 20:685-93.

104. Garattini S, Guaitani A, Mantovani A. Effect of etidronate disodium on the interactions between malignancy and bone. Am J Med. 1987; 82(Suppl 2A):29-33.

105. Jacobs TP, Gordon AC, Silverberg SJ et al. Neoplastic hypercalcemia: physiologic response to intravenous etidronate disodium. Am J Med. 1987; 82(Suppl 2A):42-50.

106. Powell JH, DeMark BR. Clinical pharmacokinetics of diphosphonates. In: Garattini S, ed. Bone resorption, metastasis, and diphosphonates. New York: Raven Press; 1985:41-9.

107. Altman RD. Long-term follow-up of therapy with intermittent etidronate disodium in Paget’s disease of bone. Am J Med. 1985; 79:583-90.

108. Perry HM III, Droke DM, Avioli LV. Alternate calcitonin and etidronate disodium therapy for Paget’s bone disease. Arch Intern Med. 1984; 144:929-33.

109. Charhon S, Chapuy MC, Valentin-Opran A et al. Intravenous etidronate for spinal cord dysfunction due to Paget’s disease. Lancet. 1982; 1:391-2.

110. Meunier PJ, Chapuy MC, Delmas P et al. Intravenous disodium etidronate therapy in Paget’s disease of bone and hypercalcemia of malignancy: effects on biochemical parameters and bone histomorphometry. Am J Med. 1987; 82(Suppl 2A):71-8.

111. Ryzen E, Martodam RR, Troxell M et al. Intravenous etidronate in the management of malignant hypercalcemia. Arch Intern Med. 1985; 145:449-52.

112. Hasling C, Charles P, Mosekilde L. Etidronate disodium for treating hypercalcaemia of malignancy: a double blind, placebo-controlled study. Eur J Clin Invest. 1986; 16:433-7.

113. Zweig JI, Shafer N. Treatment of hypercalcemia with etidronate disodium. JAMA. 1980; 244:437-8.

114. Mundy GR, Wilkinson R, Heath DA. Comparative study of available medical therapy for hypercalcemia of malignancy. Am J Med. 1983; 74:421-32.

115. Ringenberg QS, Ritch PS. Efficacy of oral administration of etidronate disodium in maintaining normal serum calcium levels in previously hypercalcemic cancer patients. Clin Ther. 1987; 9:318-25.

116. Schiller JH, Rasmussen P, Benson AB III et al. Maintenance etidronate in the prevention of malignancy-associated hypercalcemia. Arch Intern Med. 1987; 147:963-6.

117. Hagg E, Eklund M, Torring O. Disodium etidronate in hypercalcaemia due to immobilisation. BMJ. 1984; 288:607-8.

118. Merli GJ, McElwain GE, Adler AG et al. Immobilization hypercalcemia in acute spinal cord injury treated with etidronate. Arch Intern Med. 1984; 144:1286-8.

119. Meythaler JM, Korkor AB, Nanda T et al. Immobilization hypercalcemia associated with Landry-Guillain-Barré syndrome: successful therapy with combined calcitonin and etidronate. Arch Intern Med. 1986; 146:1567-71.

120. Anon. Medical management of primary hyperparathyroidism. Lancet. 1984; 2:727-8.

121. Licata AA, O’Hanlon E. Treatment of hyperparathyroidism with etidronate disodium. JAMA. 1983; 249:2063-4.

122. Scher HI, Yagoda A. Bone metastases: pathogenesis, treatment, and rationale for use of resorption inhibitors. Am J Med. 1987; 82(Suppl 2A):6-28.

123. Bounameux HM, Schifferli J, Montani JP et al. Renal failure associated with intravenous diphosphonates. Lancet. 1983; 1:471.

124. Boyce BF, Fogelman I, Ralston S et al. Focal osteomalacia due to low-dose diphosphonate therapy in Paget’s disease. Lancet. 1984; 1:821-4.

125. Procter & Gamble Pharmaceuticals. Didronel (etidronate disodium) tablets prescribing information. Cincinnati, OH; 2011 Jan.

126. Francis MD, Slough CL. Acute intravenous infusion of disodium dihydrogen (1-hydroxyethylidene)diphosphonate: mechanism of toxicity. J Pharm Sci. 1984; 73:1097-1100.

127. Food and Drug Administration. Orphan designations pursuant to Section 526 of the Federal Food and Cosmetic Act as amended by the Orphan Drug Act (P.L. 97-414), to June 28, 1996. Rockville, MD; 1996 Jul.

128. Procter & Gamble Pharmaceuticals. Actonel(risedronate sodium) tablets prescribing information. Cincinnati, OH; 2000 Apr.

129. Miller PD, Brown JP, Siris ES et al. A randomized, double-blind comparison of risedronate and etidronate in the treatment of Paget’s disease of bone. Am J Med. 1999; 106:513-20.

130. Plotkin LI, Weinstein RS, Parfitt AM et al. Prevention of osteocyte and osteoblast apoptosis by bisphosphonates and calcitonin. J Clin Invest. 1999; 104:1363-74.

131. Adachi JD, Bensen WG, Brown J et al. Intermittent etidronate therapy to prevent corticosteroid-induced osteoporosis. N Engl J Med. 1997; 337:382-7.

132. Roux C, Oriente P, Laan R et al. Randomized trial of the effect of cyclical etidronate in the prevention of corticosteroid-induced bone loss. J Clin Endocrinol Metab. 1998; 83:1128-33.

133. Adachi JD, Saag KG, Delmas PD et al. Two-year effects of alendronate on bone mineral density and vertebral fracture in patients receiving glucocorticoids: a randomized, double-blind, placebo-controlled extension trial. Arthritis Rheum. 2001; 44:202-11.

134. Reid DM, Hughes RA, Laan RF et al. Efficacy and safety of daily risedronate in the treatment of corticosteroid-induced osteoporosis in men and women: a randomized trial. J Bone Miner Res. 2000; 15:1006-20.

135. Diamond T, McGuigan L, Barbagallo S et al. Cyclical etidronate plus ergocalciferol prevents glucocorticoid-induced bone loss in postmenopausal women. Am J Med. 1995; 98:459-63.

136. Cohen S, Levy RM, Keller M et al. Risedronate therapy prevents corticosteroid-induced bone loss: a twelve-month, multicenter, randomized, double-blind, placebo-controlled, parallel-group study. Arthritis Rheum. 1999; 42:2309-18.

137. Wallach S, Cohen S, Reid DM et al. Effects of risedronate treatment on bone density and vertebral fracture in patients on corticosteroid therapy. Calcif Tissue Int. 2000; 67:277-85.

138. American College of Rheumatology Task Force on Osteoporosis Guidelines. Recommendations for the prevention and treatment of gluococorticoid-induced osteoporosis. Arthritis Rheum. 1996; 39:1791-801.

139. American College of Rheumatology Ad Hoc Committee on Glucocorticoid-induced Osteoporosis. Recommendations for the prevention and treatment of gluococorticoid-induced osteoporosis: 2001 update. Arthritis Rheum. 2001; 44:1496-503.

140. Sambrook PN. Corticosteroid osteoporosis: practical implications of recent trials. J Bone Miner Res. 2000; 15:1645-9.

141. Jenkins EA, Walker-Bone KE, Wood A et al. The prevention of corticosteroid-induced bone loss with intermittent cyclical etidronate. Scand J Rheumatol. 1999; 28:152-6.

142. Hanley DA, Ioannidis G, Adachi JD. Etridronate therapy in the treatment and prevention of osteoporosis. J Clin Densitom. 2000; 3:79-95.

143. Sebaldt RJ, Ioannidis G, Adachi JD et al. 36 month intermittent cyclical etidronate treatment in patients with established corticosteroid induced osteoporosis. J Rheumatol. 1999; 26:1545-9.

144. Cortet B, Hachulla E, Barton I et al. Evaluation of the efficacy of etidronate therapy in preventing glucocorticoid-induced bone loss in patients with inflammatory rheumatic diseases. A randomized study. Rev Rhum Engl Ed. 1999; 66:214-9.

145. Pitt P, Li F, Todd P et al. A double blind placebo controlled study to determine the effects of intermittent cyclical etidronate on bone mineral density in patients on long-term oral corticosteroid treatment. Thorax. 1998; 53:351-6.

146. Struys A, Snelder AA, Mulder H. Cyclical etidronate reverses bone loss of the spine and proximal femur in patients with established corticosteroid-induced osteoporosis. Am J Med. 1995; 99:235-42.

147. Ruggiero SL, Mehrotra B, Rosenberg TJ et al. Osteonecrosis of the jaw associated with the use of bisphosphonates: a review of 63 cases. J Oral Maxillofac Surg. 2004; 62:527-34.

148. Novartis. Zometa (zoledronic acid) injection prescribing information. East Hanover, NJ; 2004 Aug.

149. Hohneker JA. Dear doctor letter regarding osteonecrosis of the jaw in patients with cancer receiving bisphophonates. East Hanover, NJ: Novartis; 2004 September 24.

150. Ruggiero SL, Mehrotra B. Ten years of alendronate treatment for osteoporosis in postmenopausal women. N Engl J Med. 2004; 351:191.

151. Bone HG, Santora AC. Ten years of alendronate treatment for osteoporosis in postmenopausal women. N Engl J Med. 2004; 351:191-2.

152. Food and Drug Administration. Center for Drug Evaluation and Research. Dugs@FDA:Didronel. Available at Accessed 2005 Jan 4.

153. Center for Drug Evaluation and Research, Food and Drug Administration. FDA Alert: Information on bisphosphonates (marketed as Actonel, Actonel+Ca, Aredia, Boniva, Didronel, Fosamax, Fosamax+D, Reclast, Skelid, and Zometa). 2008 Jan 7. From FDA website. Accessed 2008 Oct 28.

154. Wysowski DK, Chang JT. Alendronate and risedronate: reports of severe bone, joint, and muscle pain. Arch Intern Med. 2005; 165:346-7.

155. Center for Drug Evaluation and Research, Food and Drug Administration. Update of safety review follow-up to the October 1, 2007 early communication about the ongoing safety review of bisphosphonates. Bisphosphonates: alendronate (Fosamax, Fosamax plus D) etidronate (Didronel), ibandronate (Boniva), Pamidronate (Aredia), risedronate (Actonel, Actonel w/calcium), tiludronate (Skelid), and zoledronic acid (Reclast, Zometa). 2008 Nov 12. From FDA website. Accessed 2008 Nov 21.

156. Wysowski DK. Reports of esophageal cancer with oral bisphosphonate use. N Engl J Med. 2009; 360:89-90. Letter.

157. Food and Drug Administration. FDA Drug Safety Communication: Safety update for osteoporosis drugs, bisphosphonates, and atypical fractures. Silver Spring, MD; 2010 Oct 13. From FDA website. Accessed 2010 Nov 4.

158. Shane E, Burr D, Ebeling PR et al. Atypical subtrochanteric and diaphyseal femoral fractures: report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res. 2010; 25:2267-94.

159. Food and Drug Administration. FDA News Release: Possible increased risk of thigh bone fracture with bisphosphonates. Silver Spring, MD; 2010 Oct 13. From FDA website. Accessed 2010 Nov 4.

160. Food and Drug Administration. FDA drug safety communication: Ongoing safety review of oral osteoporosis drugs (bisphosphonates) and potential increased risk of esophageal cancer. Rockville, MD; 2011 July 21. Available from FDA website. Accessed 2011 Sept 12.

161. Green J, Czanner G, Reeves G et al. Oral bisphosphonates and risk of cancer of oesophagus, stomach, and colorectum: case-control analysis within a UK primary care cohort. BMJ. 2010; 341:c4444.

162. Cardwell CR, Abnet CC, Cantwell MM et al. Exposure to oral bisphosphonates and risk of esophageal cancer. JAMA. 2010; 304:657-63.

163. Abrahamsen B, Eiken P, Eastell R. More on reports of esophageal cancer with oral bisphosphonate use. N Engl J Med. 2009; 360:1789; author reply 1791-2.

164. Abrahamsen B, et al. The risk of oesophageal and cancer incidence and mortality in alendronate users: a national cohort study. Presented at the 3rd Joint Meeting of the European Calcified Tissue Society and the International Bone and Mineral Society. Athens, Greece: May 10, 2011. Abstract No. 0C29.

165. Solomon DH, Patrick A, Brookhart MA. More on reports of esophageal cancer with oral bisphosphonate use. N Engl J Med. 2009; 360:1789-90; author reply 1791-2.

166. Grossman JM, Gordon R, Ranganath VK et al. American College of Rheumatology 2010 recommendations for the prevention and treatment of glucocorticoid-induced osteoporosis. Arthritis Care Res (Hoboken). 2010; 62:1515-26.

167. Kanis JA, Oden A, Johansson H et al. FRAX and its applications to clinical practice. Bone. 2009; 44:734-43.

173. Kasting GB, Francis MD. Retention of etidronate in human, dog, and rat. J Bone Miner Res. 1992; 7:513-22.

622. Buckley L, Guyatt G, Fink HA et al. 2017 American College of Rheumatology Guideline for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis. Arthritis Rheumatol. 2017; 69:1521-1537.

c. AHFS Drug Information. McEvoy GK, ed. Etidronate. Bethesda, MD: American Society of Health-System Pharmacists.