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Alendronate Sodium

 

Alendronate Sodium (generic Fosamax) Review

brand name: Fosamax
generic names: Alendronic acid, Alendronate sodium, Alendronate

How does it work?

Fosamax once weekly tablets contain the active ingredient alendronic acid (as sodium alendronate), which is a type of medicine called a bisphosphonate. (NB. Alendronic acid weekly tablets are also available without a brand name, ie as the generic medicine.) Bisphosphonates are medicines that prevent the breakdown of bone.

Bone is not a static structure. It is continually shaped, reformed and rebuilt by cells called osteoblasts and osteoclasts. These cells continously deposit and remove calcium and phophorous, stored in a protein network that makes up the structure of the bone. Old bone is broken down by the osteoclasts and new bone is formed by the osteoblasts.

In women at the menopause, blood levels of the female hormone oestrogen start to decrease. This results in an increase in bone breakdown by the osteoclasts, which can lead to a loss of bone density. Bone loss is particularly rapid for the first ten years after the menopause and it may lead to the development of osteoporosis - a condition in which the bones become weak and brittle and break (fracture) more easily.

Alendronic acid is used to treat osteoporosis in women who have passed the menopause. It works by binding very tightly to the bone and preventing the calcium being removed by the osteoclasts. This stops the osteoclasts from breaking down the bone, which helps to keep the bones strong and less likely to break.

In women who have passed the menopause, alendronic acid has been shown to reduce the risk of spinal and hip fractures.

As this medicine slows bone turnover and so prevents calcium being reabsorbed from the bones into the blood, it can cause the amount of calcium in your blood to fall too low. If your dietary intake of calcium and vitamin D is low, your doctor may ask you to take supplements to prevent this.

Overdosage

Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.

• Symptoms of Fosamax (Alendronate) overdose may include:
  Heartburn, ulcer, inflammation of the esophagus or stomach, upset stomach

What side effects might I notice from taking alendronate?

Side effects that you should report to your prescriber or health care professional as soon as possible:
More common:
•stomach pain
•heartburn
•pain or difficulty swallowing
Rare or uncommon:
•allergic reactions such as hives, swelling of the face, lips, throat or tongue
•black or tarry stools
•constant jaw pain, especially burning or cramping
•eye inflammation, pain or change in vision
•muscle twitching
•redness, blistering, peeling or loosening of the skin, including inside the mouth
•vomiting

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):
•diarrhea or constipation
•headache
•stomach gas or fullness
•nausea
•changes in taste
•bone, muscle or joint pain
•rash, skin rash or itching, which may be made worse by prolonged exposure to sunlight

Recommended dosage

TREATMENT OF POSTMENOPAUSAL OSTEOPOROSIS

The usual dose is one 10-milligram tablet once a day, or one 70-milligram tablet or bottle of oral solution once a week. Treatment continues for years.

STEROID-INDUCED OSTEOPOROSIS

The usual dose is one 5-milligram tablet once a day, except for postmenopausal women not taking estrogen, who should take one 10-milligram tablet once daily.

PAGET'S DISEASE

The usual dose is 40 milligrams once a day for 6 months.

PREVENTION OF POSTMENOPAUSAL OSTEOPOROSIS

The usual dose is one 5-milligram tablet once a day or one 35-milligram tablet once a week.

OSTEOPOROSIS IN MEN

The usual dose is one 10-milligram tablet once a day, or one 70-milligram tablet or bottle of oral solution once a week.

Use with caution in

• Vitamin D deficiency.
  
  
• Disorders of the parathyroid gland (gland that produces hormones responsible for regulating calcium metabolism)
  
  
• People who have had major disorders of the upper part of the digestive system in the last year, bleeding from the stomach or intestines, eg peptic ulcer , or surgery on the stomach or intestines.
  
  
• Active disorders of the upper part of the digestive system, such as inflammation of the lining of the stomach (gastritis), ulcers, disorders affecting the foodpipe (eg reflux disease ), difficulty swallowing, inflammation of the small intestine (duodenitis)
  
  
• Decreased kidney function
  
  

How should you use medication?

Fosamax (Alendronate) is effective only when each tablet or bottle of oral solution is taken with a full glass of plain water first thing in the morning, beverage, at least 30 minutes before the first food, or other medication. If you can wait longer before eating or drinking, the medication will be absorbed better. Do not lie down after taking Fosamax until at least 30 minutes have passed and you've had something to eat.

If you are taking Fosamax (Alendronate) once a week, take 1 tablet or 1 bottle of oral solution the morning after you remember, then return to your original once-weekly schedule on the chosen day. Do not take 2 doses on the same day.

You should take calcium and vitamin D supplements if you don't get enough in your diet. Avoid smoking and alcohol. Weight-bearing exercise can also strengthen bones.

--If you miss a dose...

If you are taking Fosamax (Alendronate) on a daily basis, do not take a missed dose later in the day, Instead, skip it and go back to your regular schedule the next morning.

--Storage instructions...

Keep the container tightly closed and store at room temperature. Do not freeze the oral solution.

Avoid chewing or sucking on the tablet; it can cause mouth sores.