Risedronic acid

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[edit] BRAND NAMES

[edit] STRUCTURE

Risedronic acid.jpg

[edit] MECHANISM OF ACTION

Osteoporosis happens when not enough new bone grows to replace the bone that is naturally broken down. Gradually, the bones become thin and fragile, and more likely to break. Osteoporosis is more common in women after the menopause, when the levels of the female hormone estrogen fall, since estrogen helps to keep bones healthy. Approximately 40% of 50-year-old women will experience an osteoporosis-related fracture during their remaining lifetimes.

Osteoblasts make bone, while osteoclasts resorb or take away bone. Risedronate is a bisphosphonate, it has no direct effect on bone formation, but it stops the action of the osteoclasts, the cells that are involved in breaking down the bone tissue.
Risedronate is internalized by osteoclasts, causing disruption of osteoclast cytoskeleton, loss of the ruffled border, and the subsequent loss of ability to resorb bone.

In postmenopausal women, Risedronate reduces the elevated rate of bone turnover, leading to, on average, a net gain in bone mass.

[edit] INDICATIONS

  • Treatment and prevention of postmenopausal osteoporosis (Risedronate prevent vertebral and nonvertebral fractures and increase bone mineral density)
  • Treatment to increase bone mass in men with osteoporosis
  • Treatment and prevention of glucocorticoid-induced osteoporosis
  • Treatment of Paget’s disease

[edit] DOSAGE

  • Postmenopausal Osteoporosis: 5 mg daily, 35 mg once a week, 75 mg two consecutive days each month, 150 mg once a month
  • Prevention of Postmenopausal Osteoporosis: 5 mg daily, 35 mg once a week
  • Men with Osteoporosis: 35 mg once a week
  • Glucocorticoid-Induced Osteoporosis: 5 mg daily
  • Paget’s Disease: 30 mg daily for 2 months

Swallow tablet with a glass of water, at least 30 minutes before the first food, beverage, or medication of the day. Avoid lying down for 30 minutes. Take supplemental calcium and vitamin D if dietary intake is inadequate.

[edit] CONTRAINDICATIONS

  • Hypersensitivity to Risedronate
  • Hypocalcemia
  • Inability to stand or sit upright for at least 30 minutes
  • Abnormalities of the esophagus which delay emptying such as stricture or achalasia

[edit] PRECAUTIONS

  • Bisphosphonates have been associated with esophagitis, gastritis, oesophageal ulcerations and gastroduodenal ulcers. (follow the dosing instructions carefully).
  • Bisphosphonates may cause osteonecrosis of of the jaw. Potential predisposing factors are tooth extractions, poor oral hygiene, corticosteroids use, alcohol abuse, chemotherapy and radiotherapy.
  • Atypical Femur Fractures have been reported. Patients should be advised to report any thigh or groin pain to rule out an incomplete femur fracture.
  • Severe bone, joint, muscle pain may occur. Discontinue use if severe symptoms develop

[edit] INTERACTIONS

  • Products containing calcium, including milk, and oral medications containing multivalent cations (such as aluminium, magnesium, iron), are likely to interfere with absorption of Risedronate. Patients should wait at least one-half hour before taking any other oral medications.

[edit] PREGNANCY AND LACTATION

  • Pregnancy Category C (US). Risedronate should be used during pregnancy only if the potential benefit justifies the potential risk to the mother and fetus.
  • In nursing mothers a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.

[edit] SIDE EFFECTS

Most common adverse reactions include: back pain, arthralgia, abdominal pain, and dyspepsia.

Hypersensitivity reactions (angioedema, generalized rash, bullous skin reactions), and eye inflammation (iritis, uveitis) have been reported rarely

[edit] RELATED LINKS

How osteoporosis develops

[edit] BIBLIOGRAPHY

http://www.actonel.com/global/prescribing_information.pdf

[edit] REFERENCES