Adult: 40 mg once daily for 6 mth; may be repeated if necessary after 6-mth post-treatment evaluation period.
Oral Prophylaxis of postmenopausal osteoporosis
Adult: 5 mg once daily or 35 mg once wkly.
Oral Corticosteroid-induced osteoporosis
Adult: 5 mg once daily, or 10 mg once daily in postmenopausal women not receiving oestrogen.
Oral Increase bone mass in men with osteoporosis, Postmenopausal osteoporosis
Adult: 10 mg once daily or 70 mg once wkly.
Should be taken on an empty stomach. Take w/ a full glass of plain water at least 30 min before the 1st food/drink/medication of the day & remain in sitting/upright position for at least 30 min. Swallow whole, do not chew/crush.
Effervescent tab: Dissolve in 120 mL of room temp plain water; wait for at least 5 min after effervescence stops, then stir for 10 seconds and administer.
Oesophageal abnormalities which may delay oesophageal emptying (e.g. stricture, achalasia); inability to stand or sit upright for at least 30 min; hypocalcaemia; risk of aspiration (oral soln/effervescent tab); difficulty swallowing liquids (oral soln).
Patient w/ active upper GI abnormalities; history of major GI disease (e.g. peptic ulcer, GI bleeding), or surgery of the upper GI tract other than pyloroplasty. Renal impairment. Pregnancy and lactation.
GI symptoms (e.g. abdominal pain, dyspepsia, diarrhoea, constipation), severe oesophageal reactions (e.g. oesophagitis, erosions, ulceration, stricture), peptic ulceration, osteonecrosis of the jaw, bone/joint/muscle pain, femoral fracture, hypocalcaemia, nausea. Rarely, Stevens Johnson syndrome, toxic epidermal necrolysis.
Monitor alkaline phosphatase, serum Ca and 25(OH)D levels. Re-evaluate bone density every 2 yr; height/wt measurement (annual). Perform routine dental check-ups.
Symptoms: Hypocalcaemia, hypophosphataemia, upper GI adverse events (e.g. upset stomach, heartburn, oesophagitis, gastritis, ulcer). Management: May give milk or antacids to bind alendronate. Patient should remain in upright position.
Reduced absorption w/ antacids, Ca supplements or oral medications containing multivalent cations. Increased risk of GI irritation w/ aspirin, NSAIDs.
Food and beverages reduce absorption.
May interfere w/ diagnostic imaging agents (e.g. technetium-99m-diphosphonate) in bone scans.
Description: Alendronic acid inhibits bone resorption by binding to bone hydroxyapatite and specifically inhibiting the activity of osteoclasts, the bone-resorbing cells. Pharmacokinetics: Absorption: Poorly absorbed from the GI tract. Reduced absorption w/ food and beverages. Bioavailability: Approx 0.4%. Distribution: Plasma protein binding: Approx 78%. Metabolism: Not metabolised. Excretion: Via urine (approx 50% of absorbed amount).
M05BA04 - alendronic acid ; Belongs to the class of bisphosphonates. Used in the treatment of bone diseases.
Anon. Alendronate. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 28/08/2015.Binosto Effervescent Tablet (Mission Pharmacal Company). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 28/08/2015.Buckingham R (ed). Alendronate. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 28/08/2015.Fosamax Tablet (Merck Sharp & Dohme Corp.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 28/08/2015.McEvoy GK, Snow EK, Miller J et al (eds). Alendronate Sodium. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 28/08/2015.