Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Alendronate is in a class of medications
called bisphosphonates. The bisphosphonate class includes etidronate (Didronel),
ibandronate (Boniva),
pamidronate (Aredia), risedronate (Actonel), and
tiludronate (Skelid). Bisphosphonates are used for treating osteoporosis
(reduced density of bone that leads to
fractures) and bone pain from diseases
such as metastatic breast cancer, multiple myeloma, and Paget's disease. Bone is
in a constant state of remodeling. New bone is laid down by cells called
osteoblasts while old bone is removed by cells called osteoclasts.
Bisphosphonates strengthen bone by inhibiting bone removal (resorption) by
osteoclasts. After menopause, there is an increased rate of bone loss leading to
osteoporosis, and alendronate has been shown to increase bone density and
decrease fractures of bones. The FDA approved alendronate in September 1995.
STORAGE: Tablets and solution should be stored at room temperature,
15-30 C (59-86 F) and not frozen.
PRESCRIBED FOR: Alendronate is used for treating osteoporosis in men
and postmenopausal women. It also is used for Paget's disease of bone and
osteoporosis caused by steroid treatment. Non-FDA approved (off-label) uses
include vitamin D overdose and osteoporosis caused by spinal injury.
DOSING: The recommended dose for treatment of osteoporosis is 5-10 mg
daily or 35-70 mg weekly. Paget's disease is treated with 40 mg once daily for
six months.
Since food, other medications, and vitamins can interfere with the absorption
of alendronate, they should be taken at least 30 minutes before alendronate. In
order to avoid chemical irritation of the esophagus (the swallowing tube that
connects the mouth with the stomach), alendronate should be taken with a full
glass of plain water immediately upon arising in the morning and never chewed or
sucked. It should be avoided by patients with abnormalities of the esophagus
which delay esophageal emptying, such as scarring (stricture) or poor motility
(achalasia). Patients should also not lie down for 30 minutes after swallowing
the tablets. Those patients who are unable to remain upright for at least 30
minutes after taking alendronate should not take it.
DRUG INTERACTIONS:Calcium supplements and antacids reduce the
absorption of alendronate. Therefore, alendronate should be taken at least 30
minutes before calcium and antacids.
Intravenous ranitidine (Zantac) increases blood levels of alendronate. The
importance of this reaction is unknown.
PREGNANCY: Alendronate has not been studied in
pregnant women.
NURSING MOTHERS: It is not known whether alendronate is secreted in
breast milk.
SIDE EFFECTS: The most common side effect of alendronate is stomach
pain. It also may cause nausea,
vomiting, bloating, constipation, diarrhea,
gas,
black stool (due to intestinal bleeding), change in taste perception, and muscle
or joint pain. Alendronate may irritate the esophagus, causing ulcers and
bleeding. This occurs more often when patients do not drink enough water with
alendronate, wait 30 minutes before lying down, or take alendronate before the
first meal of the day. Rarely, patients may experience jaw problems
(osteonecrosis of the jaw) associated with delayed healing and infection after
tooth extraction.
Bone, joint, and muscle pain also can occur as can femoral fractures.
Menopause is the time in a woman's life when menstrual periods permanently stop, also called the “change of life." Menopause symptoms include hot flashes, night sweats, irregular vaginal bleeding, vaginal dryness, painful intercourse, urinary incontinence, weight gain, and emotional symptoms such as mood swings. Treatment of menopausal symptoms varies, and should be discussed with your physician.
Breast cancer is the most common cancer in women and the second most common cause of cancer death in women in the U.S. Symptoms include a lump in the breast or underarm area, nipple pain, change in breast size or shape, an inverted nipple, nipple discharge, and breast skin changes. Treatment may involve chemotherapy, radiation therapy, biological therapy, hormone therapy, or surgery.
Multiple myeloma is a form of cancer that develops in plasma cells, the white blood cells that make antibodies. Symptoms include bone pain, weakness, extreme thirst, nausea, frequent urination, and broken bones. Treatment of multiple myeloma depends upon the staging and symptoms of the disease.
Learn about osteoporosis, a condition characterized by the loss of bone density, which leads to an increased risk of bone fracture. Unless one experiences a fracture, a person may have osteoporosis for decades without knowing it. Treatment for osteoporosis may involve medications that stop bone loss and increase bone strength and bone formation, as well as quitting smoking, regular exercise, cutting back on alcohol intake, and eating a calcium- and vitamin D-rich balanced diet.
Paget's disease is a chronic bone disorder due to irregular breakdown and formation of bone tissue. Symptoms of Paget's disease include bone pain, headaches and hearing loss, pressure on nerves, increased head size, hip pain, and damage to cartilage of joints.
Fractures occur when bone cannot withstand the outside forces applied to the bone. Fractures can be open or closed. Types of fractures include: greenstick, spiral, comminuted, transverse, compound, or vertebral compression. Common fractures include: stress fracture, compression fracture, rib fracture, and skull fracture. Treatment depends upon the type of fracture.
Osteopenia is a bone condition characterized by bone loss that is not as severe as in osteoporosis. Bone fracture is the typical symptom of osteopenia, though the condition may be present without symptoms. Treatment involves lifestyle modifications (quitting smoking, not drinking in excess) and ensuring an adequate intake of vitamin D and calcium.
Disease prevention in women includes screening tests that are a basic part of prevention medicine. All screening tests
are commonly available through your general doctor. Some specialized tests may be available elsewhere.
Osteopenia is a bone condition characterized by a decreased density of bone,
which leads to bone weakening and an increased risk of breaking a bone
(fracture). Osteopenia and osteoporosis are related conditions. In osteopenia,
however, the bone loss is not as severe as in osteoporosis. That means someone
with osteopenia is more likely to fracture a bone than someone with a normal
bone density but is less likely to fracture a bone than someone with
osteoporosis.
Osteomalacia, osteomyelitis, and osteoarthritis are different conditions that
are frequently confused with osteopenia because they sound similar. Osteomalacia
is a disorder of the mineralization of newly formed bone, which causes the bone
to be weak and more prone to fracture. There are many causes of osteomalacia,
including vitamin D deficiency and low blood phosphate levels. Osteomyelitis is
bone infection. Osteoarthritis is joint inflammation featuring cartilage ...
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