Formulary
Alendronic acid: Indications, Dosing, Side Effects and Interactions
Bisphosphonates are adsorbed onto hydroxyapatite crystals in bone, slowing both their rate of growth and dissolution, and therefore reducing the rate of bone...
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Alendronic acid: Indications, Dosing, Side Effects and Interactions
Bisphosphonates are adsorbed onto hydroxyapatite crystals in bone, slowing both their rate of growth and dissolution, and therefore reducing the rate of bone...
Drug action
Bisphosphonates are adsorbed onto hydroxyapatite crystals in bone, slowing both their rate of growth and dissolution, and therefore reducing the rate of bone turnover.
Indications and dose
**Treatment of postmenopausal osteoporosis**
- **Adult** (By Mouth): (female) 10 mg once daily, alternatively 70 mg once weekly.
**Treatment of osteoporosis in men**
- **Adult** (By Mouth): (male) 10 mg once daily.
**Prevention and treatment of corticosteroid-induced osteoporosis in postmenopausal women not receiving hormone replacement therapy**
- **Adult** (By Mouth): (female) 10 mg once daily.
**Osteoporosis (due to osteogenesis imperfecta and other causes) (initiated under specialist supervision), Hypercalcaemia (initiated under specialist supervision) for alendronic acid**
- **Child** (By mouth): (consult local protocol).
Cautions
Cautions, further information Elderly With oral use: Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) criteria to aid medication reviews (see Prescribing in the elderly for information): potentially inappropriate in patients with a current or recent history of upper gastro-intestinal disease or bleeding (risk of relapse/exacerbation of oesophagitis, oesophageal ulcer, or oesophageal stricture). Cautions For alendronic acid Active gastro-intestinal bleeding; atypical femoral fractures; duodenitis; dysphagia; exclude other causes of osteoporosis; gastritis; history (within 1 year) of ulcers; surgery of the upper gastro-intestinal tract; symptomatic oesophageal disease; ulcers; upper gastro-intestinal disorders
Contraindications
Abnormalities of oesophagus; hypocalcaemia; other factors which delay emptying (e.g. stricture or achalasia)
Side effects
Common or very common Alopecia; anaemia; appetite decreased; arthralgia; asthenia; chills; constipation; diarrhoea; dizziness; dysphagia; electrolyte imbalance; eye inflammation; fever; gastritis; gastrointestinal discomfort; headache; influenza like illness; malaise; myalgia; nausea; oesophageal ulcer (discontinue); oesophagitis (discontinue); pain; peripheral oedema; renal impairment; skin reactions; taste altered; vomiting Uncommon Anaphylactic reaction; angioedema; bronchospasm; oesophageal stenosis (discontinue); osteonecrosis Rare or very rare Atypical femur fracture; Stevens-Johnson syndrome Side-effects For alendronic acid Common or very common Gastrointestinal disorders; joint swelling; vertigo Uncommon Haemorrhage Rare or very rare Femoral stress fracture; oropharyngeal ulceration; photosensitivity reaction; severe cutaneous adverse reactions (SCARs) Side-effects, further information Severe oesophageal reactions (oesophagitis, oesophageal ulcers, oesophageal stricture and oesophageal erosions) have been reported; patients should be advised to stop taking the tablets and to seek medical attention if they develop symptoms of oesophageal irritation such as dysphagia, new or worsening heartburn, pain on swallowing or retrosternal pain.
Pregnancy
Avoid.
Breast feeding
Manufacturer advises avoid-no information available.
Renal impairment
Avoid if creatinine clearance less than 35 mL/minute. M See Prescribing in renal impairment .
Medicinal forms
Solution,Tablet,Tablet,Solution
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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