Table 3. Antiresorptive agents for the treatment of osteoporosis in men with prostate cancer.

Drug	Indication approved for male osteoporosis		Dosage	Recommendations for administration	Contraindications
	U.S. Food and Drug Administration	European Medicines Agency
Alendronate [4,35]	Yes	No	70 mg orally once a week	At least 30 minutes before the first food, or drink of the day with a glass of plain water; do not lie down for at least 30 minutes after taken	Gastroesophageal refluxbreakr/> Inability to stand/sit upright for at least 30 minutes Hypocalcemia Renal impairment (CrCl <35 mL/min) Scheduled dental procedures
Risedronate [4,35,49]	Yes	Yes (only 35 mg weekly formulation)	35 mg orally once a week 75 mg orally on two consecutive days each month 150 mg orally once a month	At least 30 minutes before the first food, or drink of the day with a glass of plain water; do not lie down for at least 30 minutes after taken	Gastroesophageal reflux Inability to stand/sit upright for at least 30 minutes Hypocalcemia Renal impairment (CrCl <35 mL/min) Scheduled dental procedures
Risedronate delayed-release tablets [4,35]	No	No	35 mg orally once a week	Immediately following breakfast	Hypocalcemia Renal impairment (CrCl <35 mL/min) Scheduled dental procedures
Zoledronic acid [47,48]	Yes	Yes	5 mg intravenous once a year	Infusion given intravenously over no less than 15 minutes	Hypocalcemia Renal impairment (CrCl <35 mL/min) Scheduled dental procedures
Denosumab [45,46]	Yesa	Yesa	60 mg subcutaneous every 6 month	Subcutaneous injection in the upper arm, upper thigh, or abdomen	Hypocalcemia Scheduled dental procedures

CrCl: creatinine clearance.

^aDenosumab is the only antiresorptive agent with specific indication for the treatment of bone loss associated with hormone ablation in men with prostate cancer at increased risk of fractures.