Classification: Bone growth regulator (biphosphonate)
Action/Kinetics: Binds to bone hydroxyapatite and inhibits osteoclast activity, thereby preventing bone resorption. Appears to reduce fracture risk and reverse the progression of osteoporosis. Does not inhibit bone mineralization. Well absorbed orally and initially distributed to soft tissues, but then quickly redistributed to bone. Not metabolized; excreted through the urine. t 1/2, terminal believed to be more than 10 years, due to slow release from the skeleton.
Uses: Prevention and treatment of osteoporosis in postmenopausal women. Glucocorticoid-induced osteoporosis in men and women receiving daily dosage equivalent to 7.5 mg or greater of prednisone and who have low bone mineral density. Paget's disease of bone in those with alkaline phosphatase at least two times the upper limit of normal or for those who are symptomatic or at risk for future complications from the disease.
Contraindications: In hypocalcemia. Severe renal insufficiency (C CR less than 35 mL/min). Use of hormone replacement therapy with alendronate for osteoporosis in postmenopausal women. Lactation.
Special Concerns: Use with caution in those with upper GI problems, such as dysphagia, symptomatic esophageal diseases, gastritis, duodenitis, or ulcers. Safety and effectiveness have not been determined in children or for use in male osteoporosis.
Side Effects: GI: Flatulence, acid regurgitation, esophageal ulcer, dysphagia, abdominal distention, gastritis, abdominal pain, constipation, diarrhea, dyspepsia, N&V. Miscellaneous: Musculoskeletal pain, pain, headache, taste perversion, rash and erythema (rare), back pain, glaucoma, accidental injury, edema, flu-like symptoms.
Laboratory Test Alterations: Serum calcium and phosphate.
Overdose Management: Symptoms: Hypocalcemia, hypophosphatemia, upset stomach, heartburn, esophagitis, gastritis, ulcer. Treatment: Administration of milk or antacids to bind the drug should be considered.
How Supplied: Tablet: 5 mg, 10 mg, 40 mg