Meds and you

Updated 11 February 2013

Alendronate

Alendronate is indicated for the treatment of osteoporosis in men and women and for the treatment and reduction of steroid-induced osteoporosis in those receiving corticosteroids.

0

Also known as: Alendronic acid

Brand names: Fosamax, Osteobon

Fast facts

Drug schedule: S3

Available as: Tablets

Drug group: Drugs affecting bone mineralisation

Action: Prevents bone degeneration, promotes bone regeneration

Overdose risk: Medium

Dependence danger: Low

Available as generic: Yes

Only on prescription? Yes

General information

Alendronate is indicated for the treatment of women with osteoporosis after menopause, men with osteoporosis, and for the treatment and reduction of steroid-induced osteoporosis in those receiving corticosteroids in a dosage equivalent to 7.5mg prednisone and who have a low bone mineral density. Alendronate is furthermore used to treat Paget's disease, a disorder which can lead to weakness and malformation of bones.

Alendronate tablets should be taken with a full glass of plain water first thing after getting up in the morning. Wait at least 30 minutes after taking the tablet – if you can wait longer the tablet will be absorbed better – before having the day's first meal, beverage or medication. After swallowing your alendronate tablet do not lie down. Remain upright (sitting or standing) for at least 30 minutes and until after your first food of the day. This will help the tablet reach your stomach quickly and prevent it from sticking to the throat (oesophagus) where it may cause irritation, ulcers, bleeding or even perforation. Do not bite, crush or suck alendronate tablets as this may cause mouth ulcers and increase the risk of oesophageal irritation. Do not take alendronate at bedtime

A calcium supplement with vitamin D and a vitamin C supplement may aid in the formation of new bone tissue if dietary amounts are not adequate. These should, however, not be taken at the same time as alendronate as it will affect alendronate absorption.

How alendronate works

Alendronate works by reducing the activity of osteoclasts, the cells that cause bone loss, without affecting the cells responsible for building new bone, the osteoblasts. Alendronate ultimately enables you to add bone because it allows your body's osteoblasts to continue to work while your osteoclasts are inhibited by the drug.

Your body will no longer lose more bone than your cells are making and will slowly begin to add new bone. Exercise will help even more.

The full effect of alendronate will be seen after 1-3 years.

User information

Dietary advice: For alendronate to be effective you must take the tablets without food or other medications. Take the medication with plain water, not mineral water – the minerals may have a possible effect on alendronate absorption.

Stopping this medicine: Only your doctor should decide when you should stop treatment with alendronate. If you stop prematurely the condition being treated may worsen. Patients with Paget’s disease usually follow a six-month course, which may have to be repeated at a later stage.

Prolonged use: Prolonged use carries no special precautions.

Special precautions

Consult your doctor before taking alendronate if:

  • you have an oesophageal disease or battle to swallow,
  • you are unable to stand or sit upright for at least 30 minutes,
  • your blood levels of calcium are low,
  • you have kidney disease, or
  • you have stomach ulcers or other digestive problems including heartburn.

Pregnancy: Avoid. Alendronate is contraindicated in women who are, or may become pregnant. Studies in animals and/or humans have shown clear foetal risk.

Breast feeding: Avoid, as alendronate may pass into breast milk.

Infants and children: Alendronate is contraindicated in children.

Elderly: No special precautions.

Driving and hazardous work: No special precautions.

Alcohol: Alcohol may enhance stomach irritation. It is also a risk-factor for developing osteoporosis.

Possible side effects:

Side effect

Frequency

Consult your doctor

Common

Rare

Only if severe

In all cases

Abdominal pain

x

x

Oesophagitis

x

x

Nausea/vomiting

x

x

Stomach/duodenal ulcers

x

x

Diarrhoea/constipation

x

x

Muscle and/or bone pain

x

x

Headache

x

x

Skin rash

x

x

Interactions:

Drug interactions:

Amino glycoside antibiotics

Increased risk of low calcium levels in body

Antacids, iron and mineral supplements, calcium-containing products

Reduce alendronate absorption. Take at least 2 hours from taking alendronate.

Nonsteroidal anti-inflammatory drugs (NSAIDs) and aspirin

Increased possibility of upper gastro-intestinal events

Osmotic laxatives

Reduce alendronate absorption. Take at least 2 hours from taking alendronate.

Disease interactions:

Contact your doctor before using alendronate if you have an oesophageal disease or battle to swallow, if you are unable to stand or sit upright for at least 30 minutes, if your blood levels of calcium are low, if you have kidney disease, or if you have stomach ulcers or other digestive problems, including heartburn.

Recommended dosage:

Osteoporosis: 10mg once daily or 70mg once weekly

Steroid-induced osteoporosis: 10mg once daily

Paget's disease: 40mg daily for 6 months

Overdose action:

Seek immediate medical advice. Patient should try to remain upright.

Interesting facts

The term given by scientists to the link between alendronate, a bisphosphonate, and jaw necrosis is 'bis-phossy jaw'. This is derived from the 19th-century term phossy jaw, given its name after workers in match factories working with white phosphorus who developed necrosis of the jaw.

This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.

 

Read Health24’s Comments Policy

Comment on this story
0 comments
Comments have been closed for this article.