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<<tiddler AutoRefresh with: force>>

hx of fragility fracture .. over 75 give bisphosphonates 
under 75 do dexa (T score <-2.5) and treat if positive using score - FRAX or Q fracture 

All take Vit D and Ca unless convinced adequate
1st line alendronate
25% don't tolerate alendronate (GI upset) - switch to risedronate or etidronate 
strontium and raloxifene if bisphosphonates not tolerated
Denosumab - strictest guide

complex tables to use if alendronate not tolerated - look at age, Tscore, parental Hx fracture, alcohol (>4u/day), RA