Pregnancy Risk Category C
How supplied
Tablets: 5 mg, 10 mg, 40 mg
Action
Suppresses osteoclast activity on newly formed resorption surfaces, which reduces bone turnover. Bone formation exceeds resorption at remodeling sites, leading to progressive gains in bone mass.
Indications & dosage
Osteoporosis in postmenopausal women, prevention of fractures--
Adults: 10 mg P.O. daily, taken with water only, at least 30 minutes before first food, beverage, or medication of day.
Paget's disease of bone--
Adults: 40 mg P.O. daily for 6 months, taken with water only, at least 30 minutes before first food, beverage, or medication of day.
Prevention of osteoporosis in postmenopausal women--
Adults: 5 mg P.O. daily, taken with water only, at least 30 minutes before first food, beverage, or medication of day.
NEW INDICATION: Glucocorticoid-induced osteoporosis in men and women receiving glucocorticoids in a daily dose equivalent to 7.5 mg or more of prednisone and who have low bone mineral density--
Adults: 5 mg P.O. daily, taken with water only, at least 30 minutes before first food, beverage, or medication of day. For postmenopausal women not receiving estrogen, recommended dose is 10 mg P.O. daily taken with water only, at least 30 minutes before first food, beverage, or medication of day.
Adverse reactions
CNS: headache.
GI: abdominal pain, nausea, dyspepsia, constipation, diarrhea, flatulence, acid regurgitation, esophageal ulcer, vomiting, dysphagia, abdominal distention, gastritis, taste perversion.
Musculoskeletal: musculoskeletal pain.
Interactions
Drug-drug. Antacids, calcium supplements: may interfere with drug absorption. Tell patient to wait at least 30 minutes after taking alendronate before taking other drugs.
Aspirin, NSAIDs: increased risk of upper GI adverse reactions with drug doses above 10 mg/day. Monitor patient closely.
Hormone replacement therapy: not recommended for use with alendronate in treating osteoporosis; evidence of effectiveness is lacking. Avoid concurrent use.
Ranitidine: increased availability of alendronate. Reduce dosage, as needed.
Drug-food. Any food: decreased absorption of drug. Administer with full glass of water at least 30 minutes before eating, drinking, or ingesting other drugs.
Effects on diagnostic tests
None reported.
Contraindications
Contraindicated in patients with hypersensitivity to drug and in those with hypocalcemia, severe renal insufficiency, or abnormalities of the esophagus that delay esophageal emptying.
Nursing considerations
Patient teaching
*Liquid contains alcohol. **May contain tartrazine. †Canada ‡Australia §U.K. OTCOver the counter
Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE-THREATENING