Evidence-based recommendations on alendronate (Fosamax), etidronate (Didronel), risedronate (Actonel), raloxifene (Evista), strontium ranelate (Protelos) and teriparatide (Forsteo) for preventing osteoporotic fragility fractures in postmenopausal women who have osteoporosis.

This guidance has been partially updated by NICE’s technology appraisal guidance on bisphosphonates for treating osteoporosis.

NICE has withdrawn its guidance on the use of etidronate and strontium ranelate for the secondary prevention of osteoporotic fragility fractures in postmenopausal women because etidronate and strontium ranelate are no longer marketed in the UK.

This guidance replaces NICE technology appraisal guidance on the clinical effectiveness and cost effectiveness of technologies for the secondary prevention of osteoporotic fractures in postmenopausal women (TA87).

Guidance development process

How we develop NICE technology appraisal guidance

Your responsibility

The recommendations in this guidance represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, health professionals are expected to take this guidance fully into account, alongside the individual needs, preferences and values of their patients. The application of the recommendations in this guidance is at the discretion of health professionals and their individual patients and do not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.

Commissioners and/or providers have a responsibility to provide the funding required to enable the guidance to be applied when individual health professionals and their patients wish to use it, in accordance with the NHS Constitution. They should do so in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities.

Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.

  • National Institute for Health and Care Excellence (NICE)