{"id":1616,"date":"2023-06-25T17:27:16","date_gmt":"2023-06-25T17:27:16","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/alendronic-acid\/"},"modified":"2023-06-25T19:57:12","modified_gmt":"2023-06-25T19:57:12","slug":"alendronic-acid","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/alendronic-acid\/","title":{"rendered":"Alendronic acid"},"content":{"rendered":"

<\/p>\n

Alendronic acid<\/h1>\n

CLINICAL USE<\/h3>\n

Treatment and prophylaxis of osteoporosis<\/p>\n

DOSE IN NORMAL RENAL FUNCTION<\/h3>\n

5\u201310 mg daily or 70 mg once weekly<\/p>\n

PHARMACOKINETICS<\/h3>\n
  • Molecular weight                           :
    \n249.1 (325.1 as
    \nsodium salt)<\/li>\n
  • %Protein binding                           :
    \n78<\/li>\n
  • %Excreted unchanged in urine     :
    \nApprox 50<\/li>\n
  • Volume of distribution (L\/kg)       :
    \n28 litres<\/li>\n
  • half-life \u2013 normal\/ESRD (hrs)      :
    \n>10 years\/Increased<\/p>\n

    DOSE IN RENAL IMPAIRMENT<\/h3>\n

    GFR (mL\/MIN)<\/h4>\n

    35\u201350 Dose as in normal renal function
    \n<35
    \nAvoid. See \u2018Other Information\u2019<\/p>\n

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES<\/h3>\n<\/li>\n
  • CAPD                :
    \nUnlikely to be dialysed. Dose as in
    \nGFR<35 mL\/min<\/li>\n
  • HD                     :
    \nNot dialysed. Dose as in
    \nGFR<35 mL\/min<\/li>\n
  • HDF\/high flux   :
    \nUnknown dialysability. Dose as in
    \nGFR<35 mL\/min<\/li>\n
  • CAV\/VVHD      :
    \nUnlikely to be dialysed. Dose as in
    \nGFR<35 mL\/min<\/p>\n

    IMPORTANT DRUG INTERACTIONS<\/h3>\n

    Potentially hazardous interactions with other drugs
    \nCalcium salts: reduced absorption of<\/p>\n

    alendronate<\/p>\n

    ADMINISTRATION<\/h3>\n

    Reconstition<\/h4>\n

    \u2013<\/p>\n

    Route<\/h4>\n

    Oral<\/p>\n

    Rate of Administration<\/h4>\n

    \u2013<\/p>\n

    Comments<\/h4>\n

    \u2013<\/p>\n

    OTHER INFORMATION<\/h4>\n<\/li>\n
  • Swallow whole with a glass of water on anempty stomach, at least 30 minutes before
    \nbreakfast and any other oral medication<\/li>\n
  • Patient should stand or sit upright for atleast 30 minutes after taking tablets<\/li>\n
  • Combination therapy with alendronate andintravenous calcitriol, for the treatment
    \nof secondary hyperparathyroidism in
    \nhaemodialysis patients, has been used
    \nat a dose of 10 mg alendronate plus IV
    \ncalcitriol 2 mcg post dialysis to reduce
    \nPTH levels. (McCarthy JT, Kao PC,
    \nDemick DS, et al. Combination therapy
    \nwith alendronate and intravenous
    \ncalcitriol for the treatment of secondary
    \nhyperparathyroidism in hemodialysis
    \npatients. J Am Soc Nephrol. 1999; 10
    \nProgram, 81A\u201382A.)
    \nManufacturers do not recommend use of<\/p>\n

    alendronate in severe renal impairment
    \ndue to lack of data<\/li>\n

  • One paper reviewed all the informationavailable and concluded that 50% of the
    \nrecommended dose may be possible
    \nin ESRD, but more trials are required
    \nand osteomalacia and adynamic bone
    \ndisease must first be excluded. (Miller
    \nPD. Treatment of osteoporosis in chronic
    \nkidney disease and end-stage renal disease.
    \nCurr Osteoporos Rep. 2005; 3: 5\u201312.)<\/li>\n
  • Anecdotally, several renal units use either70 mg weekly or standard doses of all
    \npreparations in patients with CKD 3, 4 and
    \n5 to good effect<\/li>\n","protected":false},"excerpt":{"rendered":"

    Alendronic acid CLINICAL USE Treatment and prophylaxis of osteoporosis DOSE<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-1616","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1616","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=1616"}],"version-history":[{"count":1,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1616\/revisions"}],"predecessor-version":[{"id":2914,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1616\/revisions\/2914"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=1616"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=1616"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=1616"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}