| name | Alendronate |
| classification | Bisphosphonate, Antiresorptive agent |
| pharmacokinetics | | absorption | Poorly absorbed from the GI tract; bioavailability is very low, typically less than 1%. Absorption is highly dependent on gastric pH and is generally absorbed more effectively when given on an empty stomach (at least 30 minutes before food or other medications). | | distribution | Distributed throughout the body, primarily to bone. | | metabolism | Minimal metabolism, primarily excreted unchanged in the urine. | | elimination | Elimination is primarily renal. The half-life is highly variable, ranging from 10 to 60 hours. The drug is extensively bound to bone. This slow elimination and strong bone binding can lead to prolonged effects. |
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| suggested dosage | | oral | | general | Individualized based on indication. The most common dosage for osteoporosis prevention/treatment is 70mg once weekly. | | patient specific | For a 70kg male patient at 25 years of age, the starting dosage should be determined by a medical professional in accordance with clinical guidelines. A doctor must assess the patient's specific condition to determine the appropriate dosage. | | notes | Always follow the prescription instructions given by the physician. Do not adjust the dosage without medical supervision. |
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| indications | | 1 | Postmenopausal osteoporosis in women | | 2 | Osteoporosis in men | | 3 | Paget's disease of bone | | 4 | Corticosteroid-induced osteoporosis |
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| safety in pregnancy | Category C. Alendronate should not be used during pregnancy unless the potential benefits outweigh the potential risks. There are no adequate and well-controlled studies in pregnant women. Animal studies have shown adverse effects on the fetus. |
| safety in breastfeeding | Not recommended. The drug is present in breast milk and can potentially affect the infant. The potential benefits must be weighed against the potential risks. |
| side effects | | 1 | Gastrointestinal effects (most common): | | 2 | Dyspepsia (heartburn, indigestion) | | 3 | Esophagitis | | 4 | Esophageal ulcer | | 5 | Abdominal pain | | 6 | Nausea/Vomiting | | 7 | Other side effects: | | 8 | Muscle/Bone Pain | | 9 | Headache | | 10 | Fatigue | | 11 | Jaw Osteonecrosis (ONJ) (rare but serious risk, particularly with long-term use or high doses) | | 12 | Atrial fibrillation |
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| contraindications | | 1 | Esophageal abnormalities (e.g., stricture, achalasia) | | 2 | Inability to stand or sit upright for at least 30 minutes after taking the medication | | 3 | Hypocalcemia (low blood calcium) | | 4 | Known hypersensitivity to alendronate or any components of the drug |
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| interactions | | 1 | Antacids and calcium supplements | | 2 | Other oral medications (may reduce absorption) |
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| warnings and precautions | | 1 | Take on an empty stomach (at least 30 minutes before food or other medications). | | 2 | Remain upright (sitting or standing) for at least 30 minutes after taking the medication to minimize esophageal irritation. | | 3 | Monitor for signs of esophageal irritation (e.g., chest pain, difficulty swallowing). | | 4 | Patients with a history of esophageal problems should consult with a healthcare provider before taking alendronate or similar medications. | | 5 | Risk of jaw osteonecrosis (ONJ) with long-term use, especially in combination with cancer therapy. Caution is warranted. |
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| additional informations | | 1 | Alendronate is a potent antiresorptive agent. It inhibits osteoclast activity, decreasing bone resorption. | | 2 | It is crucial to discuss individual risk factors and potential benefits and harms with a medical professional before starting this medication. |
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