Adverse Effects

With the exception of the possible development of a hypervitaminosis associated with high-dose administration of vitamin D2 or D3, the compounds discussed in this chapter are relatively safe. Allergic reactions to the injection of calcitonin and PTH have occurred and chronic use of some bisphosphonates has been associated with the development of osteomalacia. The principal side effects of intravenous bisphosphonates are mild and include low-grade fever and transient increases in serum creatinine and phosphate levels. Oral bisphos-phonates are poorly absorbed and can cause esophageal and gastric ulceration. They should be taken on an empty stomach; the individual must remain upright for 30 minutes after ingestion.

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