risedronate, Actonel, Atelvia

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GENERIC NAME: risedronate

BRAND NAME: Actonel, Atelvia

DRUG CLASS AND MECHANISM: Risedronate is in a class of drugs called bisphosphonates used for the treatment of Paget's disease of bone (in which the formation of bone is abnormal) and in persons with osteoporosis (in which the density and strength of bones are reduced). Other biphosphonates include the drugs alendronate (Fosamax), ibandronate (Boniva), pamidronate (Aredia), tiludronate (Skelid), and etidronate (Didronel). Bone is continually being formed and dissolved. 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. By slowing down the rate at which bone is dissolved, risedronate increases the amount of bone. Risedronate is more potent in blocking the dissolution of bone than etidronate and alendronate. The FDA approved risedronate for the treatment of Paget's disease in 1998 and for the prevention and treatment of osteoporosis in 1999.

GENERIC AVAILABLE: Yes

PRESCRIPTION: Yes

PREPARATIONS: Tablets: 5, 30, 35, and 150 mg. Tablets (Delayed release): 35 mg

STORAGE: Tablets should be stored at room temperature, 15-30 C (59-86 F).

PRESCRIBED FOR: Risedronate is used for the treatment of Paget's disease of bone (osteitis deformans), treatment and prevention of postmenopausal osteoporosis in women, and treatment of osteoporosis in men. It also is used to prevent and treat osteoporosis caused by steroid medications (glucocorticoid-induced osteoporosis).

DOSING:

  • For post menopausal osteoporosis, 5 mg of risedronate is taken once daily, 35 mg is taken weekly or 150 mg is taken monthly.
  • Osteoporosis in men is treated with 35 mg weekly.
  • Paget's disease is treated with 30 mg daily for two months, and steroid-induced osteoporosis is treated with 5 mg daily.

Risedronate should be taken with 6 to 8 ounces of plain water. Because food interferes with the absorption of risedronate, it should be taken first thing in the morning before anything is eaten or liquids consumed. Also, no food or drink should be taken for at least 30 minutes after taking risedronate. To avoid pills sticking and irritating the throat or esophagus, persons should not lie down for at least 30 minutes after taking risedronate. It also should not be taken at the same time as iron supplements, vitamins with minerals, or antacids containing calcium, magnesium, or aluminum which reduce the absorption of risedronate.

DRUG INTERACTIONS: Food, calcium, antacids, and medications containing iron, magnesium, or aluminum reduce the absorption of risedronate, resulting in loss of effectiveness. Thus, it should be taken with plain water only.

PREGNANCY: The safety and effectiveness of risedronate has not been established in pregnant women. Physicians must therefore weigh the potential benefits and unknown risks carefully.

NURSING MOTHERS: The safety of risedronate for the infant has not been established in women who breastfeeding.

SIDE EFFECTS: The most common side effects of risedronate are headache, joint pain, diarrhea, abdominal pain, rash, high blood pressure, and nausea. Severe irritation of the esophagus (for example, esophagitis, esophageal ulcers, esophageal erosions) can occur. This occurs more often when patients do not drink enough water with risedronate, or do not wait 30 minutes before lying down. Rarely, patients may experience jaw problems (osteonecrosis of the jaw) associated with delayed healing and infection after tooth extraction.

Reference: FDA Prescribing Information


Last Editorial Review: 3/28/2012




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