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ONCE WEEKLY tablets

ONCE DAILY tablets

Reserve for patients with swallowing difficulties.

Reserve for patients who have tried alendronate and/or risedronate but are unable to swallow tablets (as opposed to patients with swallowing difficulties in whom the oral solution may be appropriate).

AdcalD3/ AccreteD3 twice daily formulations are the preferred calcium and vitamin D supplements.   Accrete D3 One a Day, Calci-D chewable tablets or theiCal-D3 chewable tablets are once daily options for patients with compliance issues.  

SASH- Adcal D3 is preferred product. 

150mg tablets 
(note - 50mg tablets are not licensed for this indication)

Weekly tablets are 35mg. Daily tablets are 5mg.
NOTE - 30mg tablets are licensed for Paget's disease only

Rheumatology only in secondary care. 
Restricted to use in patients for whom bisphosphonates are unsuitable.

Prescribe by brand:

Practices are to select the preferred biosimilar brand that they wish to use from Jubbonti or Stoboclo.

Patients that are discharged from hospital having been initiated on another denosumab biosimilar (potentially Zadenvi® locally) or Prolia® the originator product, should be changed to the preferred locally agreed products. See Patient Information Sheet.

Patients with a CKD of 4 or 5 and patients with a T-score of < -4.5 to remain under specialist care.

Only recommended as an option in secondary prevention where other options have been exhausted.

Post-menopausal osteoporosis in women. Rheumatology only. 
See separate entry for use in men and juveniles.
Biosimilar teriparatide is recommended. Prescribe by brand.

5mg annual infusion

Strontium ranelate granules have only been available as an unlicensed product for several years but have now been discontinued (Sep 2025).