risedronate sodium

CLINICAL USE

Treatment and prevention of post- menopausal osteoporosis (including corticosteroid induced)Paget’s disease

DOSE IN NORMAL RENAL FUNCTION

Post-menopausal osteoporosis: 5 mg daily or 35 mg weeklyPaget’s disease: 30 mg daily for 2 months

PHARMACOKINETICS

Molecular weight :305.1

%Protein binding :24

%Excreted unchanged in urine : 50

Volume of distribution (L/kg) :6.3

half-life – normal/ESRD (hrs) :480/Increased

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : See ‘Other Information’

<10 : See ‘Other Information’

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Unknown dialysability. Dose as in GFR <10 mL/min

HD :Unknown dialysability. Dose as in GFR <10 mL/min

HDF/high flux :Unknown dialysability. Dose as in GFR <10 mL/min

CAV/VVHD :Unknown dialysability. Dose as in GFR 10 to 20 mL/min

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsCalcium-containing substances: avoid for 2 hours before and after administration

ADMINISTRATION

Reconstition

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Route

Oral

Rate of Administration

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Comments

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OTHER INFORMATION

Swallow whole with a glass of water 30 minutes before food. Sit or stand upright for 30 minutes after administrationRenal clearance is decreased by 70% in patients with creatinine clearance <30 mL/minNo data, but one paper suggests using a decreased dose when GFR< 20 mL/min.
One paper reviewed all the information available and concluded that 50% of the recommended dose may be possible in ERF, but more trials are required, and osteomalacia and adynamic bone disease must first be excluded. Examples of use in other units in HD patients: Normal doses; 5 mg once weekly

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