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Apo-Alendronate

Apo-Alendronate

How does this medication work? What will it do for me?

Alendronate belongs to a family of medications known as bisphosphonates. It is used to treat and prevent osteoporosis for postmenopausal women. It is also used to treat osteoporosis for men.

Alendronate may also be used to treat and prevent steroid-induced osteoporosis for men and women (osteoporosis caused by taking corticosteroids such as prednisone for long periods of time). It may also be used to treat Paget's disease of the bone for both men and women.

Alendronate increases the thickness of bone (bone mineral density) by slowing down the cells that usually break down bone (osteoclasts). This allows the cells that build bone (osteoblasts) to work more efficiently. By making bones stronger, alendronate can help to reduce the incidence of osteoporosis-related fractures.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

5 mg

Each white, round, flat-faced, bevelled-edged tablet, engraved "A" on one side and "5" on the other, contains alendronate monosodium salt trihydrate 6.53 mg, which is the molar equivalent to alendronate 5 mg. Nonmedicinal ingredients: magnesium stearate, mannitol, and microcrystalline cellulose.

10 mg

Each white, round, biconvex tablet, engraved "APO" on one side and "10" on the other, contains alendronate sodium equivalent to alendronate 10 mg. Each tablet contains alendronate monosodium salt trihydrate 13.05 mg, which is the molar equivalent to alendronate 10 mg. Nonmedicinal ingredients: magnesium stearate, mannitol, and microcrystalline cellulose.

70 mg

Each white, oval, biconvex tablet, engraved "APO" on one side and "ALE70" on the other, contains alendronate sodium salt trihydrate 91.35 mg, which is molar equivalent to alendronate 70 mg. Nonmedicinal ingredients: magnesium stearate, mannitol, and microcrystalline cellulose.

How should I use this medication?

When used for postmenopausal women, the recommended dose of alendronate to treat osteoporosis is one 10 mg tablet daily or 70 mg once weekly. To prevent osteoporosis, the recommended dose is 5 mg once a day.

To treat osteoporosis for men, the recommended dose of alendronate is one 10 mg tablet daily or 70 mg once weekly.

To treat and prevent steroid-induced osteoporosis for men and women, the recommended dose is 5 mg daily, except for postmenopausal women not taking estrogen. For those women, the recommended dose is 10 mg once a day.

When used to treat Paget's disease of the bone for men and women, the recommended dose is 40 mg once a day for 6 months.

The tablet should be taken upon rising for the day, at least 30 minutes before the first food, beverage, or medication of the day. To reduce the risk of irritating the throat or esophagus, take the tablet with a full glass (250 mL) of plain water only.

After swallowing, do not lie down until at least 30 minutes have passed and you have eaten your first food of the day. Swallow the tablets whole. Do not chew or suck on the tablets.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important that this medication be taken exactly as prescribed by your doctor. If you miss a dose when taking this medication once a day, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

If you miss a dose when taking this medication once weekly, take the missed dose the morning after you remember. Then return to your weekly dose on the original day of the week. Do not take 2 doses on the same day. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take alendronate if you:

 

  • are allergic to alendronate or any ingredients of the medication
  • cannot stand or sit upright for at least 30 minutes
  • have an abnormality of the esophagus (passage leading from throat to stomach) that delays the emptying of the esophagus into the stomach
  • have low blood calcium
  • have severely reduced kidney function

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • abdominal pain
  • bloating
  • constipation
  • diarrhea
  • gas
  • headache
  • heartburn
  • mild skin rash or redness
  • nausea
  • pain in bones, muscles, or joints

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

What other drugs could interact with this medication?

There may be an interaction between alendronate and any of the following:

aminoglycoside antibiotics (e.g., amikacin, gentamicin, tobramycin)

antacids (e.g., aluminum hydroxide, calcium carbonate, magnesium hydroxide)

ASA and ASA-containing products (when alendronate is taken in doses greater than 10 mg daily) - note that this does not apply to the 70 mg weekly dose

calcium supplements (wait at least 30 minutes after taking alendronate to take calcium supplements)

deferasirox

H2 antagonists (e.g., famotidine, ranitidine)

non-steroidal anti-inflammatory medications (NSAIDs; e.g., diclofenac, ibuprofen, naproxen)

proton pump inhibitors (e.g., lansoprazole, omeprazole)

systemic angiogenesis inhibitors (e.g., axitinib, bevacizumab, lenalidomide, pazopanib, regorafenib, vandetanib)

supplements containing minerals such as aluminum, calcium, iron, magnesium and phosphate

other medications given by mouth (wait at least 30 minutes after taking alendronate to take any other medication by mouth)

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

 

stop taking one of the medications,

change one of the medications to another,

change how you are taking one or both of the medications, or

leave everything as is.

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