Plan to prescribe intravenous bisphosphonate (i.e., zoledronate/zoledronic acid) for at least 3 years and then re-assess fracture risk. Longer durations of treatment, for at least 6 years, are recommended in the following men and women:

1. • Age ≥70 years at the time that the bisphosphonate is started
   • Who have a previous history of a hip or vertebral fracture(s)
   • Treated with oral glucocorticoids ≥7.5 mg prednisolone/day or equivalent
   • Who experience one or more fragility fractures during the first 3 years of treatment (if treatment is not changed).

If a new fracture occurs after zoledronate treatment is discontinued, reassess using FRAX and restart treatment.

If zoledronate treatment is discontinued (treatment pause/break) and no new fracture occurs, reassess using FRAX after 3 years to inform whether treatment should be restarted.