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Alendronate (Fosamax)
Available:
10 mg and 70 mg tablets, 70 mg/75 mL
oral solution
Dose: 10
mg daily or 70 mg weekly
Cost: 70
mg, 4 tablets = $66.99
Indications:
Prevention or treatment of
osteoporosis, including corticosteroid-induced osteoporosis;
treatment of Paget�s disease
Common To
All Oral
Bisphosphonates
Side
effects: Nausea, vomiting,
abdominal pain, or change in bowel movements are the most
common side effects. Rarely, bleeding may occur, although the
risk is much higher in patients with strictures in the
esophagus or in those at high risk for ulcer disease.
Headache, bone/muscle pain, and an altered taste sensation are
less common side effects.
Monitoring:
Follow-up bone density testing is recommended every 1-2
years to assess efficacy of therapy. Urinary markers of bone
turnover, which should be suppressed on bisphosphonates, are
another way to monitor the therapeutic effect of these
medications. Yearly blood counts and blood chemistry studies
are prudent, particularly calcium, phosphorus, and magnesium
levels.
Important
points to know: All oral bisphosphonates should be taken
after getting out of bed for the day prior to consuming any
food or liquids. Do not take these medications at bedtime or
any other time of the day. The medication should be swallowed
with a full glass (6-8 oz.) of plain water only.
Do not use mineral water, coffee, tea, juice, or other
liquids. Do not chew or suck on these tablets. After
swallowing the tablet, do not lie down; stay fully upright
(sitting, standing, or walking) or consume any food, liquids,
or medications (including antacids) for at least 30 minutes.
These guidelines prevent complications from the medication
staying in contact too long with the lining of the esophagus,
allow passage of the medication into the stomach, and ensure
that the drug is properly absorbed. If you have chest pain,
new or worsening heartburn, or pain with swallowing, call your
health care provider for further guidance. Also alert your
provider if you have a history of swallowing difficulties,
strictures in the esophagus, have impaired kidney function,
low blood levels of calcium, or are unable to sit or stand
upright for 30 minutes after taking the medication.
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