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Osteoporosis, No renal impairment, hypocalcaemia or vitamin D deficiency?,…

- - - - Not from a NH
        and can sit upright to have it
        
        if cancer educate discuss with patient higher risk of osteonecrosis.
        
        Start bisphosphonate and vitamin D with GP follow up
        Encourage adequate calcium intake
        
        Reassess fracture risk after 3-5 years
      - can consider IV bisphosphonates in those with oesophageal disease
  - - - Calcium level, vitamin D level ok
        necessary before starting denosumab
        
        Start denosumab and vitamin D.
        if CrCl >30. Encourage adequate calcium intake