RT Book, Section A1 Fitzgerald, Paul A. A2 Papadakis, Maxine A. A2 McPhee, Stephen J. A2 Rabow, Michael W. A2 McQuaid, Kenneth R. SR Print(0) ID 1184697635 T1 Osteoporosis T2 Current Medical Diagnosis & Treatment 2022 YR 2022 FD 2022 PB McGraw-Hill Education PP New York, NY SN 9781264269389 LK accessmedicine.mhmedical.com/content.aspx?aid=1184697635 RD 2024/03/28 AB Key Clinical Updates in OsteoporosisDoses of vitamin D3 above 4000 international units daily in adults are generally not advised (except in patients with intestinal malabsorption), since gastrointestinal side effects or hypercalcemia may occur.Vitamin D should not be taken with topical calcipotriene to avoid hypercalcemia.The effects of denosumab on bone wane quickly after 6 months and patients can experience a dramatic increased risk of multiple vertebral fractures within 1–2 years following discontinuation of denosumab.Therefore, denosumab must be given on-schedule without drug holidays.Denosumab should not be discontinued without substituting another anti-resorptive agent (bisphosphonate, estradiol, or SERM) or other therapy.