What should a physician do before starting romosozumab in a patient with hypocalcemia?

When considering the initiation of romosozumab in a patient with hypocalcemia, it is essential for the physician to first correct the hypocalcemia before starting the treatment. Romosozumab is a monoclonal antibody that affects bone metabolism, and understanding its safety profile is important. Hypocalcemia can increase the risk of adverse effects related to calcium metabolism, making it critical to ensure that serum calcium levels are within the normal range prior to treatment.

Administering romosozumab without correcting hypocalcemia could potentially lead to serious complications, such as exacerbating the low calcium level and increasing the risk for cardiovascular events or skeletal issues due to further complications related to bone metabolism. Thus, the emphasis on correcting hypocalcemia prior to initiating therapy is aligned with established clinical guidelines to ensure patient safety and treatment efficacy.

The other options do not appropriately address the critical nature of resolving hypocalcemia before starting romosozumab therapy. Continuing a bisphosphonate or re-evaluating the treatment decision does not specifically address the immediate need to manage the patient's calcium levels. Additionally, avoiding romosozumab due to swallowing issues is unrelated to the management of hypocalcemia, as this medication is administered as a subcutaneous injection and would not typically