Bisphosphonate Therapy for Avascular Necrosis

Administration and Monitoring

• The National Comprehensive Cancer Network recommends a dental examination with preventive dentistry intervention before initiating bisphosphonate therapy to reduce the risk of osteonecrosis of the jaw 1, 2
• Calcium supplementation (1,200-1,500 mg daily) and vitamin D (400-800 IU) should accompany bisphosphonate therapy, as recommended by the National Comprehensive Cancer Network 1, 3
• Monitor serum creatinine before each dose of intravenous bisphosphonate to assess renal function, and consider dose reduction in patients with moderate renal impairment 3
• Approximately one-third of patients may experience acute-phase reactions within the first 3 days after intravenous bisphosphonate infusion, according to Praxis Medical Insights 3
• The risk of osteonecrosis of the jaw increases with longer duration of bisphosphonate therapy, as reported by the National Comprehensive Cancer Network 1, 2