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Alendronate (Alendronic acid) 💊
📚 Related Subjects: | Calcium Physiology | Hypercalcaemia | Bisphosphonates | Osteoporosis | Osteonecrosis of the Jaw
⚠️ Key Safety Notes: Osteonecrosis of the jaw may be seen in cancer patients – always obtain a 🦷 dental assessment before treatment. Atypical femoral fractures are rare but reported with prolonged therapy. 👉 Review risks/benefits after ≥5 years of bisphosphonate use. ✅ Ensure patients are replete with calcium + vitamin D before starting.
📖 About
Always check the BNF link here.
- 💊 Bisphosphonate used in postmenopausal osteoporosis, Paget’s disease, bone metastases, and breast cancer with bone involvement.
⚡ Mechanism of Action
- ⬇️ Inhibits osteoclastic bone resorption, preserving bone density and reducing fracture risk.
🩺 Indications & Administration
- Osteoporosis (postmenopausal, glucocorticoid-induced, male osteoporosis).
- Paget’s disease of bone.
- Bone pain due to metastases (specialist use).
- 📌 Administration rules:
- Take on an empty stomach, at least 30 minutes before breakfast or other medicines.
- 💧 Swallow whole with a full glass of water.
- 🧍♂️ Stay upright (sitting or standing) for ≥30 minutes afterwards to prevent oesophageal irritation.
💊 Dose Range (always verify in BNF/datasheet)
| Name | Details |
|---|---|
| Alendronic acid |
Dose: 10 mg OD
Route: PO |
| Alendronic acid |
Dose: 70 mg once weekly
Route: PO |
⚠️ Interactions
- ⬆️ Risk of GI ulcers with NSAIDs or Aspirin.
- Absorption reduced by calcium/iron supplements, antacids → separate dosing.
🚫 Contraindications
- Achalasia, oesophageal stricture, or motility disorders.
- Other oesophageal abnormalities delaying gastric emptying.
- ❌ Hypocalcaemia.
- Renal impairment: avoid if eGFR < 35 mL/min/1.73m².
💥 Side Effects
- 🤢 GI upset: abdominal pain, dyspepsia, constipation, diarrhoea, flatulence.
- 🩸 Oesophageal ulcer, melaena, dysphagia, distension, acid regurgitation.
- 💪 Musculoskeletal pain, headache.
- ⬇️ Hypocalcaemia and hypophosphataemia.
- 🌡️ Rash, hypersensitivity reactions.
- 🦴 Femoral stress fractures (rare).
- 🦷 Osteonecrosis of the jaw (esp. after dental extraction, cancer patients).
📑 References
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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