NEWLY DISCOVERED USES (OFF-LABEL)
Bone loss reduction in spinal cord injury
ORIGINAL USES (ON-LABEL)
Osteoporosis in postmenopausal females, osteoporosis in males, osteoporosis caused by steroid drugs in males and females with low bone mineral density who are receiving a daily dosage of prednisone, Paget’s disease
BRAND NAME Fosamax
DRUG CLASS
Bisphosphonate derivative
DESCRIPTION
This drug reduces bone breakdown via actions on osteoblasts (cells that produce protein in the bone), which indirectly increases bone mineral density.
POTENTIAL SIDE EFFECTS
Low levels of calcium and phosphate, abdominal pain, gastric acid reflux, headache, stomach upset, nausea and flatulence.
CAUTIONS
Do not use this drug if you have low levels of calcium.
Do not use this drug if you have abnormalities of the esophagus which delay esophageal emptying.
Do not use this drug if you are unable to sit upright or stand for at least 30 minutes.
Do not use this drug if you have decreased kidney function.
Low levels of calcium must be corrected before therapy is started; ensure that you have adequate calcium and vitamin D
This drug is irritating to the gastric tissue and should be used with caution if you have swallowing difficulties, esophageal disease, gastritis, or ulcers.
DRUG INTERACTIONS
Ranitidine (intravenous), aspirin-containing products. All oral medications may interfere with the absorption of this drug. Wait at least 30 minutes after taking alendronate before taking any oral medications.
FOOD INTERACTIONS
All foods and beverages interfere with the absorption of this drug. Do not eat or drink anything but water within 30 minutes of taking this medication; if you fail to follow these directions, it can decrease your body’s absorption of the drug up to 60%.
HERBAL INTERACTIONS
Unknown, except as stated above with absorption problems.
PREGNANCY AND BREAST-FEEDING CAUTIONS
FDA Pregnancy Risk Category C. Excretion into breast milk is unknown; use with caution in breast-feeding.
SPECIAL INFORMATION
Take this medication first thing in the morning with a full glass of plain water, at least 30 minutes before your first intake of food, beverage, or medication of the day. Do not take at night. Do not suck or chew the tablet. You should remain standing or sitting for at least 30 minutes and until first meal of the day to prevent esophageal erosion. Contact your doctor if you develop difficulty swallowing, pain on swallowing, chest pain, or new or worsening heartburn. You may need to take supplemental vitamin D and calcium while taking this medication.
