The use of the drug Tevabon for the treatment of osteoporosis

Tevabon is a combination drug developed for the therapy of osteoporosis. The remedy is a set of tablets and capsules.

The active substance of the tablets is alendronic acid. They are flat, round in shape, their color is white or almost white, they have a bevel, on one side they engrave the letter "T".

The active substance of the capsules is alfacalcidol. The capsules themselves are gelatinous opaque oval, white or almost white, with an engraved "1.0" made in black ink, a pale yellow oily liquid is placed inside the capsules.

Mechanism of action

Alendronic acid refers to bisphosphonates, blocks the process of bone destruction, provoked by osteoclasts, does not directly affect the formation of new bone tissue.

Differs affinity to hydroxyapatite bone and is deposited mainly in areas of its active destruction. The substance increases the mineralization of bone and improves its mechanical properties.

Alfacalcidol is a precursor of vitamin D and regulates calcium-phosphorus metabolism. Increases absorption of calcium and phosphorus in the intestines, reduces their excretion from the body with urine, lowers the level of parathyroid hormone in the blood.

On the background of therapy with the preparation, a bone of normal histological structure is formed. In addition, alfacalcidol increases muscle strength, which reduces the risk of fractures.

In combination, both these substances increase the strength of bones, their therapeutic effects complement each other. This combination can reduce the risk of deficiency and excess calcium in the blood, reduce its secretion in the urine.

Medical properties of the drug

The pharmacokinetics of the drug are due to the properties of its constituents.

Alendronic acid

The highest bioavailability of the active substance is observed when taken 2 hours before breakfast.

If this time is reduced by half an hour, bioavailability drops by 40%, if you take the drug and drink it with orange juice or coffee, then the bioavailability will decrease by 60%.

When a substance enters the body, it first penetrates into soft tissues, and then passes into the bones and is fixed or excreted from the body in an unchanged form with urine.

Bone is released very slowly.

Properties of alfacalcidol

After oral administration, it is rapidly adsorbed from the digestive system. The peak concentration is observed after 8-12 hours after a single dose.

Bioavailability for oral administration is almost 100%.Once in the body, it undergoes a hydroxylation reaction and turns into calcitrol. It is excreted in equal amounts and through the kidneys and through the intestine. The half-life is 35 hours.

Indications and contraindications for the use of

The indication for the prescription of a medicinal substance are:

• various forms of osteoporosis;
• Paget's disease.

Absolute contraindications to the prescription of the drug are:

• pathologies in which there is a slowdown in the movement of food through the esophagus( including stenosis or achalasia of the esophagus);
• inability of the patient to be in an upright position for at least half an hour;
• is a deficiency or excess of calcium;
• Burnett syndrome;
• severe renal pathology;
• excess of vitamin D;
• elevated level of phosphorus in the blood, if it is not caused by hypoparathyroidism;
• hypermagnesia;
• lack of sucrose, carbohydrate intolerance;
• hypersensitivity to active and accessory components;
• patients on hemodialysis;
• pregnancy;
• lactation;
• age to 18 years.

Relative contraindications to the prescription of the medicine are:

• pathology of the digestive system in the acute stage;
• deficiency of vitamin D;
• kidney stone disease;
• decreased parathyroid function;
• calcium absorption impairment;
• chronic heart failure;
• kidney disease, with creatine clearance above 35 ml / min;
• active form of pulmonary tuberculosis;
• is anemia;
• lymphoma;
• Bénye-Beck-Schauman disease.

Scheme of application and dosage

Tablets of alendronic acid in a dosage of 70 mg are taken 2 hours before the first meal 1 time in 7 days. They can not be chewed and rassasyvat, washed down only with simple water. After reception, you must sit or stand for half an hour.

Capsules of alfacalcidol are taken every day for 1 mcg at night.

They should be swallowed whole by washing with water.

The course of therapy is long, selected individually.

Cases of overdose and first aid

When the dose of alendronic acid increases, calcium and phosphorus deficiency, liquid stool, and ulceration of the esophagus may occur.

To bind the active substance you need to take antacids, if they were not at hand you could drink a glass of milk.

Overdose of alfacalcidol shows an excess of vitamin D. Of the early signs of hypervitaminosis,

• liquid stools are possible;
• constipation;
• metallic taste in the mouth;
• nausea and vomiting;
• appearance of calcium in the urine;
• increase in urine formation;
• pathological thirst;
• dry mouth;
• night and frequent urination;
• asthenia;
• headache;
• pain in muscles and bones.

From late signs of excess vitamin D may manifest:

• weight loss;
• photophobia;
• redness of the eye mucosa;
• pancreatitis;
• stomach pain;
• kidney stone disease;
• arterial hypertension;
• confusion;
• mood swings.

In chronic intoxication of alfacalcidol calcium is observed in the visceral organs, heart and kidney failure, disruption of skeletal formation in children. Therapy consists in the abolition of capsules, there is no specific antidote.

Mineral oil taken at the beginning of an acute overdose reduces absorption and increases excretion of alfacalcidol with feces.

In severe cases, infusion solutions of salts, loop diuretics, glucocorticosteroids, bisphosphonates, calcitonin, dialysis with solutions with a lower concentration of calcium are shown.

It is necessary to monitor the level of electrolytes in the systemic circulation, the function of the kidneys and the heart, especially in patients taking digoxin.

Pharmacological compatibility

Alendronic acid can not be used concurrently with medicines, foods and beverages containing calcium. The interval between them should be at least half an hour.

Glucocorticosteroids increase the negative effects of alendronic acid on the digestive system.

With the parallel use of alfacalcidol:

• with cardiac glycosides , the likelihood of arrhythmia increases;
• inhibitors of microsomal enzymes of the liver lower, and inductors - increases the level of the substance in the plasma;
• adsorption of the substance decreases with its concurrent administration with Vaseline oil, colestyramine, colestipol, sucralfate, albumin, antacid agents , - the interval between them should be 2 hours;
• in women in the perimenopause , the effect of alfacalcidol can be enhanced by estrogen.

Assignment to special categories of patients

The drug should not be prescribed to women during pregnancy, as an excessive calcium excess can adversely affect the development of the fetus.

It is not known whether active substances enter the mother's milk, but it is better to transfer the infant to the mixture for the duration of treatment.

There is insufficient evidence to prove the safety of the drug in pediatrics, so it is not used in the treatment of children and adolescents.

Possible Adverse Reactions

Adverse reactions to Tevabon may occur as a reaction to its active ingredients.

When using alendronic acid:

• from the digestive tract : abdominal pain, indigestion, acidic eructation, diarrhea, constipation, swallowing, bloating, gastritis, stomach ulcer, nausea, vomiting, esophagitis, stenosis, erosion and perforation of the esophagus,black Hippocrates disease, sores in the mouth, gastrointestinal bleeding;
• from the musculoskeletal system : bone pain, myalgia, arthralgia, muscle cramps, osteonecrosis, atypical hip fractures;
• from the metabolism of : hypocalcemia, hypophosphatemia;
• from the CNS side : headache;
• from the viewpoint of : uveitis, scleritis, episcleritis;
• allergy : rashes, itching, erythema;photosensitivity, nettle fever, Quincke's edema, Stevens-Johnson syndrome and Lyell's syndrome;
• other : transient signs resembling influenza( occur, usually at the beginning of therapy).

The following reactions are possible with the use of alfacalcidol:

• from the metabolism of : hypercalcemia, slight increase in lipid levels in the blood plasma, hyperphosphatemia;
• from the digestive tract : anorexia, vomiting, heartburn, abdominal pain, nausea, xerostomia, obstipation, loose stool, slight increase in hepatic enzyme activity in plasma;
• from the side of the central nervous system : asthenia, dizziness;
• from the heart : heart palpitations;
• from the musculoskeletal system : slight pain in the muscles, bones, joints;
• allergic reactions : anaphylaxis, rash, itching.

The voice of the people

From the reviews of doctors and patients who took the drug Tevabon for the treatment of osteoporosis.

Special instructions

Against the backdrop of treatment, it is worth noting driving, as the drug can affect the central nervous system and cause dizziness, drowsiness.

During treatment it is necessary to monitor the level of calcium in the body. Once every 3 months, you need to take a detailed blood test and a clinical urine test.

How can I replace a drug?

The drug should be stored in a place inaccessible to children at a maximum of 25 ° C.The drug should not be taken without a doctor's prescription.

At present only partial Tevabon analogues are found in pharmacies, such as:

• Strongos;
• Forosa;
• Tevanath.

Selection of analogues should be carried out by a specialist.