Alendronate

Question 1

Drug Class

Answer 1

Bisphosphonates

Question 2

Active

Answer 2

Alendronate

Question 3

Indications

Answer 3

Paget’s disease of bone

Prevention and treatment of osteoporosis

Hypercalcaemia of malignancy

Question 4

Dose Range

Answer 4

10mg daily

OR

70mg once a week

Question 5

SE’s

Answer 5

• oesophagitis, oesophageal erosions and ulcers (mainly with alendronate)
• hypocalcaemia
• hypophosphataemia
• n/v
• diarrhoea
• musculoskeletal pain
• headache
• osteonecrosis of jaw (rare)

Question 6

Counselling

Answer 6

• Take in the morning with a full glass of plain water at least 30 minutes before food or drink. Remain upright during this time and until after you eat.
• Swallow whole; do not chew or suck on the tablet.
• Do not take antacids, calcium, iron or mineral supplements within 30 minutes of alendronate as they may interfere with its absorption.
• Stop tablets and see your doctor immediately if you have pain on swallowing, or new or worsening heartburn.
• There are rare complications with some dental procedures in people taking bisphosphonates; tell your doctor if you require any dental work and tell your dentist that you are taking this medicine (or have taken it in the past).
• Tell your doctor if you have severe pain in your bones, joints or muscles while taking this medicine.
• Ensure adequate intake of calcium and vitamin D (taken at different times to alendronate)

Question 7

Monitoring

Answer 7

• Bone Mineral Density (BMD)
• Falls risk assessment
• Levels of Calcium and vitamin D
• full dental assessment