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The ACP updates treatment recommendations for low bone density and osteoporosis. Physicians should prescribe the bisphosphonates alendronate, risedronate, and zoledronic acid, or the biologic denosumab, for women with osteoporosis and use generic drugs when possible, according to updated guidelines from the American College of Physicians (ACP) ( The ACP strongly recommends against the use of menopausal estrogen or estrogen plus progestogen therapy or the selective estrogen receptor modulator raloxifene to treat osteoporosis. Osteoporosis drugs should be taken for five years, and bone density need not be monitored during that time. Women with normal bone density do not need frequent monitoring. The new guidelines did not evaluate calcitonin, etidronate, and pamidronate. The effectiveness of calcium or vitamin D alone are uncertain.