about Alendronate class, uses, side effects contraindications
Alendronate
Short Description
Alendronate is a drug that blocks the osteoclast cells that digest bone, commonly used to treat?women?with osteoporosis in?menopause??and beyond, and patients with?Paget's disease?(inflammation of deforming bones) ).?
Alendronate is also used to prevent and treat osteoporosis caused by the use of glucocorticoids in menopausal women and men.
It is worth noting that in women who suffer from osteoporosis, treatment with alendronate should be combined with the addition of calcium and vitamin D, as needed, in addition to exercise. It is also desirable to consult a family doctor or a gynecologist regarding hormone replacement therapy.
Category
Chemical class: Aminobisphosphonate
Therapeutic class: Bone resorption inhibitor
Pregnancy category: C
Indications
To prevent postmenopausal osteoporosis
Adults.5 mg daily or 35 mg once/wk in the morning with a full glass of water at least 30 min before first food, drink, or drug. To treat postmenopausal osteoporosis
Adults. 10 mg daily or 70 mg once/wk in the morning with a full glass of water at least 30 min before first food, drink, or drug. To treat Paget’s disease of the bone in patients whose alkaline phosphatase level is twice the upper limit of normal or higher and who are symptomatic and at risk for further complications
Adults. 40 mg daily with a full glass of water for 6 mo.
DOSAGE ADJUSTMENT Dosage increased to 10 mg daily for postmenopausal women not receiving estrogen. To increase bone mass in men with osteoporosis
Adults. 10 mg daily or 70 mg once/wk in the morning with a full glass of water at least 30 min before first food, drink, or drug. To treat glucocorticoid-induced osteoporosis in men and women who receive a daily glucocorticoid dosage of 7.5 mg of greater of prednisone and who have low bone mineral density
Adults.5 mg daily in the morning with a full glass of water at least 30 min before first food, drink, or drug. Route Onset Peak Duration P.O. Unknown Unknown 6 wk*
Mechanism of Action
Reduces activity of cells that cause bone loss, slows rate of bone loss after menopause, and increases amount of bone mass. May act by inhibiting osteoclast activity on newly formed bone resorption surfaces, which reduces the number of sites where bone is remodeled. Bone formation then exceeds bone resorption at these remodeling sites, which gradually increases bone mass. May also inhibit bone dissolution by binding to hydroxyapatite crystals, which are composed of calcium, phosphate, and hydroxide and give bone its rigid structure.
Contraindications
Esophageal abnormalities that delay esophageal emptying, such as stricture or achalasia; hypersensitivity to alendronate; hypocalcemia; inability to stand or sit upright for at least 30 minutes
Interactions
antacids, calcium, iron, multivalent cations: Decreased absorption of alendronate aspirin: Increased risk of GI distress any food: Delayed absorption and decreased serum level of alendronate
Side Efect
CNS: Asthenia, dizziness, headache, vertigo
CV: Peripheral edema
GI: Abdominal distention and pain, constialendronate sodium 40 * After single 5-mg dose for osteoporosis; 6 mo after single 5-mg dose for Paget’s disease. pation, diarrhea, dysphagia, esophageal perforation or ulceration, esophagitis, flatulence, gastritis, gastroesophageal reflux disease, heartburn, indigestion, melena, nausea, vomiting
MS: Arthralgia, bone pain, focal osteomalacia, joint swelling, muscle spasms, myalgia
SKIN: Photosensitivity, pruritus, rash, Stevens-Johnson syndrome, toxic epidermal necrolysis
Other: Hypocalcemia
Cautions
Monitor patient’s serum calcium level before, during, and after treatment. Expect hypocalcemia to be treated before alendronate therapy. If hypocalcemia occurs during therapy, expect prescriber to order a calcium supplement. Ensure adequate dietary intake of calcium and vitamin D before, during, and after treatment.
WARNING Alendronate may irritate upper GI mucosa, causing Side Efect
such as esophageal ulceration. To help minimize these reactions, have patient take drug with a full glass of water and remain upright for at least 30 minutes. PATIENT SAFTY
Advise patient to take alendronate in the morning with a full glass of water. Explain that beverages such as orange juice, coffee, and mineral water reduce alendronate’s effects. To help reduce esophageal irritation, tell patient not to chew or suck on tablet. Instruct patient to wait at least 30 minutes after taking alendronate before eating, drinking, or taking other . Teach patient to remain upright for 30 minutes after taking alendronate and until she has eaten the first food of the day. Encourage patient to consume adequate daily amounts of calcium and vitamin D.
Trade Name & Company Name
effect of Alendronate in Pregnancy, Fetal Health
and Breast feeding
Pregnancy
. There are no adequate reports or well-controlled studies of alendronate in pregnant women. There appears only one case report of its use during pregnancy; the woman did respond. Alendronate is superior to conjugated estrogens (with or without medroxyprogesterone) for the prevention of bone loss in elderly women, though the combination is superior. Fetal Health
There are no adequate reports or well-controlled studies in human fetuses. Adult plasma levels are usually below the level of detection. There was no evidence of teratogenicity in two case series. Alendronate crosses the rodent placenta, decreasing bone density and delaying delivery. Both the total and ionized calcium are reduced in the rodent mother and fetus. The toxic effects are reversed by calcium administration. 17 Breastfeeding
There is no published experience in nursing women. It is unknown whether alendronate enters human breast milk. However, the risk to the breastfed neonate is likely low considering the low maternal systemic levels.
the follwing drugs will increse Alendronate by inhepiting cyp450
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the follwing drugs will decrease Alendronate by inhancing cyp450
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trad drugs based on Alendronate
| Gen name | Trade name | Catagory name |
| alendronate | Binosto | Bisphosphonates |
| alendronate | Fosamax | Bisphosphonates |
| alendronate / cholecalciferol | Fosamax Plus D | Bisphosphonates |
| Alendronate | ALENDRO | |
| Alendronate | BONAMAX 35MG TABLETS | |
| Alendronate | BONAMAX 70MG TABLETS | |
| Alendronate | DROLATE 70 MG FILM COATED TABLETS | |
| Alendronate | FOSAMAX 10MG TAB | |
| Alendronate | FOSAMAX ONCE WEEKLY 70MG TAB | |
| Alendronate | LENDOMAX 70 MG TABLETS | |
| Alendronate | OSTEO- MEPHA 70MG FC TABLETS | |
| Alendronate | OSTEODENS 70MG TABLETS | |
| Alendronate | OSTEOMAX 70 MG TABLETS | |
| Alendronate | OSTEVE 35MG TABLETS | |
| Alendronate | OSTEVE 70 MG TABLETS | |
other drugs from same cataogory