| Bisphosphonates |
| Alendronate(Fosamax) | 10 mg daily | $854 ($1,066) | Esophageal irritation | For treatment of osteoporosis and corticosteroid- induced osteoporosis | Avoid in patients with renal failure (creatinine clearance < 30 mL per minute per 1.73 m2 [0.50 mL per second per m2]); instruct patients taking oral forms to take dose first thing in the morning with6 to 8 oz of water on an empty stomach, and to not recline for at least 60 minutes |
| 70 mg weekly | $428†($1,268) |
| Ibandronate (Boniva) | Oral: 2.5 mg daily | NA ($1,332‡) | Esophageal irritation with oral forms; flu-like symptoms after first IV dose; osteonecrosis of the jaw§ |
| Oral: 150 mg monthly | NA ($1,395) |
| IV: 3 mg every three months | NA ($1,897) |
| Risedronate (Actonel) | 5 mg daily | NA ($1,511) | Esophageal irritation |
| 35 mg weekly | NA ($1,552) |
| 75 mg on two consecutive days monthly | NA ($1,316‡) |
| 150 mg monthly | NA ($1,507) |
| Zoledronic acid (Reclast) | 5 mg IV over 15 minutes once every 12months | NA ($1,137) | Flu-like symptoms after first dose; osteonecrosis of the jaw§ | FDA-approved to increase bone mass in men with osteoporosis | Avoid in patients with low calcium levels or kidney problems |
| Parathyroid hormone |
| Teriparatide (Forteo) | 20 mcg daily subcutaneously | NA ($11,538) | Dizziness, nausea, palpitations | For treatment of osteoporosis in men who are at high risk of fracture | Maximum duration of treatment is two years; contraindicated in patients with a history of bone malignancy, Paget disease, or hypercalcemia, or who received skeletal radiation |
