Alendronic acid refers to bisphosphonates containing nitrogen and is a synthetic analogue of pyrophosphate, the main substance of bone.
The substance selectively inhibits bone resorption, reduces the activity of osteoclasts.
Restores bone tissue, increases its mineral density.
Table of contents
- Pharmaceutical properties of the
- tool Indications for use
- Prohibitions and limitations
- Assignment to a specific category of patients
- Possible side effects
- Scheme of administration and dosage
- Overdose cases
- Drug compatibility
- Precautions
- What preparations contain alendronic acid
- Special instructions
- Expert opinion
- In practice, everything is as follows
Pharmaceutical properties of the
agent When administered internallybased on alendronic acid, 25% of the substance is absorbed. The average absolute bioavailability of tablets( 10 mg) taken 120 minutes before breakfast is 0.6%.
If this time is reduced to 30-60 minutes, the bioavailability is reduced by 40%.If you drink tablets with orange juice or coffee, then the bioavailability is reduced to 60%, taking 120 minutes after eating on this indicator affects insignificantly.
After intravenous injection at a dosage of 1 mg / kg the active substance is quickly distributed in soft tissues, then quickly moves to the bone or is excreted through the kidneys unchanged. The terminal half-life is more than 10 years.
Indications for use
Alendronic acid, preparations based on it and analogues are successfully used in such diseases:
- osteoporosis in postmenopausal women( for prevention of skeletal fractures);
- osteoporosis in men;
- deforming ostosis;
- hypercalcemia on the background of cancer.
Prohibitions and Restrictions
Absolute contraindication to prescription of alendronic acid preparations is:
- hypersensitivity;
- the patient's inability to stay upright for 30 minutes;
- child bearing;
- Breastfeeding;
- child and adolescence.
Since lactose is present as excipients in tablets containing alendronic acid, they are contraindicated in the following pathologies:
- lactose intolerance;
- disorders of galactose absorption.
Before starting treatment, you need to weigh the pros and cons if the patient has:
- abnormalities of the gastrointestinal tract at the stage of exacerbation( including swallowing disorders, stomach ulcer and duodenal ulcer, etc.);
- achalasia and stenosis of the esophagus;
- CRF;
- hypovitaminosis D;
- deficiency of calcium.
Assignment to a specific category of patients
It is not necessary to prescribe a drug to women in the situation, since it is known that alendronic acid negatively affects the fetus.
Against the background of treatment, it is advisable to transfer the child to artificial feeding, since it is not known whether the active substance penetrates into the mother's milk.
No, data proving the safety of the drug in pediatrics.
It is not necessary to prescribe a drug to patients with CK less than 35 ml / min.
Possible side effects of
There is a risk of developing the following undesirable effects on the background of alendronic acid therapy:
- Gastrointestinal tract : gastralgia, meteorisms, constipation or diarrhea, swallowing act disorder, esophageal erosion, belching, nausea, osteonecrosis,
tarry stool, stomatitis; - of the musculoskeletal system : myalgia, arthralgia, hip fracture, swelling of the joints, muscle cramps;
- of skin : erythema, rashes, photosensitivity, Stevens-Johnson cider and Lyell;
- CNS : headache, dizziness, perversion of taste;
- organs of vision : uveitis, episcleritis;
- Allergy : angioedema, urticaria.
At the beginning of treatment, general weakness, fever, peripheral edema can be observed. These side effects do not require drug withdrawal.
Application and dosage regimen
For oral administration, alendronic acid preparations should be administered 2 hours before breakfast. You can not chew the medicine, you can drink only with water.
In the treatment of osteoporosis, women are prescribed in a dosage of 10 mg / day, for prophylaxis the dose is reduced by 2 times.
With Paget's disease, the dosage is increased to 40 mg / day, the course of therapy lasts up to six months.
Tablets in a dosage of 70 mg coated with a coat should be taken 1 time in 7 days. In case of a pass, you need to take the medicine the next morning after awakening. Then take the scheme once a week.
The doctor selects the duration of therapy individually, depending on the severity of the disease.
Overdose Cases
In case of accidental or intentional overdose, there is a deficiency of minerals( calcium and phosphorus), liquid stools, heartburn, esophageal erosion.
The appointment of antacid preparations containing calcium is shown, they can be replaced by milk. Treatment is symptomatic, do not induce vomiting, there is a high probability of irritation of the esophagus.
The injured person can not take a horizontal position.
Drug compatibility
Medicines containing calcium, including antacids, reduce the absorption of alendronic acid.
The interval between taking medication and alendronic acid should be at least 60 minutes. Ranitidine increases bioavailability by a factor of 2, but what does it matter is not known.
When combined with NSAIDs, side effects on the gastrointestinal tract are increased.
Precautions
To reduce irritation to the upper parts of the digestive tract, the tablet should be taken in the morning immediately after lifting, squeezing 250 ml of plain water.
Other drinks should not be used as they reduce the absorption of the active substance. You can not drink a medicine at night, as the probability of esophagitis increases.
That's why after taking medication you need 30 minutes to be in an upright position. 
In case of undesirable effects on the part of the digestive tract, such as prolonged heartburn, epigastric pain, dysphagia, you should consult your doctor to exclude the development of esophageal perforation.
Before starting therapy if there is a calcium deficiency, it is necessary to first adjust its level in the body. This is especially important for patients receiving SCS.
Dental surgical manipulations increase the likelihood of osteonecrosis of the jaw, especially in patients who do not comply with oral hygiene, cancer patients receiving chemotherapy who receive SCS.
What preparations contain alendronic acid
The pharmaceutical industry produces the following preparations containing alendronic acid:
- Alendrocern;
- Ostalon;
- Alental and many others.
Special instructions
Since the course of treatment is long, it is necessary to take out an extended blood test, blood biochemistry and clinical urine analysis once a quarter.
It should be especially careful when driving, because of the intake of alendronic acid, it is possible to reduce concentration and dizziness.
On the background of therapy, you must adhere to a diet enriched with calcium and vitamin D, if necessary, you should take medicine medicines containing calcium.
Specialist opinion
Drugs, the active ingredient of which is alendronic acid, have proved to be highly effective in the treatment of various types of osteoporosis and elevated levels of calcium in the blood on the background of oncology.
Although most patients are well tolerated, they also have a number of side effects, so self-medication is not permissible.
The development of unwanted reactions from the digestive tract is especially dangerous. But they usually arise if the medicine is taken incorrectly.
Anatoly Vasilievich, rheumatologist
In practice, everything is as
Alendronic acid and preparations based on it are very popular among patients, which is confirmed by numerous reviews.
I am suffering from osteoporosis for a long time. The doctor prescribed alendronic acid, the first time there was a flu-like condition, but after a while it passed. I transfer the drug well.
Anastasia
The doctor prescribed preparations of alendronic acid and against the background of her NSAID administration, as a result, a stomach ulcer was discovered. Treatment to me have canceled.
Maxim
Alendronic acid preparations are available on prescription. Store them at a temperature not exceeding 25 degrees, in a place inaccessible to children.
