GENERIC NAME: alendronate

BRAND NAME: Fosamax

DRUG CLASS AND MECHANISM: Alendronate is in a class of medications used to strengthen bone. Bone is in a constant state of remodeling, whereby old bone is removed by cells called osteoclasts, and new bone is laid down by cells called osteoblasts. Alendronate inhibits bone removal by the osteoclasts.

PRESCRIPTION: yes

GENERIC AVAILABLE: yes

PREPARATIONS: tablet: 10mg (daily); 70mg (weekly)

STORAGE: Store at room temperature, sealed container, avoid moisture.

PRESCRIBED FOR: Alendronate is used to treat osteoporosis (thinning of bone) in women after menopause . After menopause, there is an increased rate of bone loss (resorption). In these patients, alendronate has been shown to increase bone density while strengthening bone, and decrease the rate of bone fractures. Alendronate is also helpful in the treatment of Paget's disease of the bone. Paget's disease is characterized by a disorderly and accelerated remodeling of the bone, leading to bone weakness and pain.

DOSING: Since food, other medications, and vitamins can interfere with the absorption of alendronate, it should be taken at least 30 minutes before food, beverage, vitamins or medicines. In order to avoid chemical irritation of the esophagus (the tube that connects the mouth with the stomach), alendronate should be taken with a full glass of plain water first thing in the morning and never chewed or sucked. It should be avoided by patients with abnormalities of the esophagus which delay esophageal emptying, such as scarring (stricture) or poor motility ( achalasia ). Patients should also not lie down for 30 minutes after swallowing the tablets. Those patients who are unable to remain upright for at least 30 minutes after taking medication should avoid alendronate.

DRUG INTERACTIONS: The safety of alendronate in patients with significant kidney disease is not known. Therefore, it is not recommended for patients with significant kidney conditions. Since alendronate can lower blood calcium, low blood calcium levels are corrected prior to use. Calcium supplements, antacids and medications can interfere with the absorption of alendronate.

PREGNANCY: The safety and effectiveness of alendronate has not been established in children or women who are pregnant or nursing.

NURSING MOTHERS: The safety and effectiveness of alendronate has not been established in children or women who are pregnant or nursing.

SIDE EFFECTS: Alendronate is generally well tolerated. Side effects are infrequent and mild. Side effects include stomach pain or upset, constipation , diarrhea , muscle ache, and headache. Alendronate can irritate the esophagus to cause heartburn in patients who lie down flat after swallowing, thereby delaying passage of the medication to the stomach.

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