Topic overview

Start with the big picture

Denosumab reduces bone resorption by binding RANKL and inhibiting osteoclast formation, function, and survival; the source describes subcutaneous administration every six months and notes hypocalcemia as a contraindication. SERMs have tissue-selective estrogen effects: raloxifene reduces vertebral fracture risk and LDL but does not provide hip-fracture benefit, while tamoxifen’s uterine activity is associated with endometrial cancer risk. The topic also introduces bazedoxifene with conjugated estrogens, strontium ranelate, and fluoride. Beyond bone-directed therapies, it covers calcimimetics that lower PTH and serum calcium, diuretics with differing effects on calcium excretion, and other agents used in hypercalcemia. Together, these examples show why mechanism, clinical role, and adverse effects must be considered alongside one another.