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Review article: Biomedical intelligence

Vol. 144 No. 2526 (2014)

Bisphosphonate induced hypocalcaemia – report of six cases and review of the literature

  • Veronika Kreutle
  • Claudine Blum
  • Christian Meier
  • Miriam Past
  • Beat Müller
  • Philipp Schütz
  • Katrin Borm
Cite this as:
Swiss Med Wkly. 2014;144:w13979


Intravenous bisphosphonates are widely used to treat osteoporosis and bone metastasis in cancer patients

The risk of hypocalcaemia is a rare but underestimated side effect of anti-resorptive treatment. Clinically apparent hypocalcaemia is mostly related to high-dose treatment with zoledronate and denosumab in cancer patients

Particular caution is mandatory in all malnourished patients and patients with renal failure who are treated for either bone metastases or osteoporosis.

To avoid serious hypocalcaemia, pre-treatment calcium and vitamin D status should be assessed and corrected if appropriate.


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