| name | Alendronate |
| Classification | Bisphosphonate, Nitrogen containing |
| Pharmacokinetics | Alendronate is poorly absorbed from the GI tract. High oral bioavailability (but significant first-pass effect). Primarily excreted unchanged in the urine. Significant bone deposition. T1/2 is highly variable, but generally a few days or weeks depending on the specific formulation and patient factors. |
| suggested dosage | | typical adult dosage | 70mg once weekly or 10mg once daily, depending on the indication | | patient specific details | Dosage should be individualized based on the patient's renal function and specific clinical indications. | | adjustments for renal impairment | Alendronate dose adjustments are needed in patients with significant renal impairment. |
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| indications | Prevention and treatment of osteoporosis in postmenopausal women and men at risk. Paget's disease of bone. Treatment of glucocorticoid-induced osteoporosis. Prophylaxis and treatment of Paget's disease of bone. |
| Safety in pregnancy | Alendronate is contraindicated in pregnancy. Its use in pregnancy should be avoided. |
| Safety in breastfeeding | Limited data available, but it is not recommended in lactating women. |
| side effects | Common: gastrointestinal upset (e.g., heartburn, abdominal pain, dysphagia). Less common but more serious: esophageal ulceration, osteonecrosis of the jaw (ONJ), atypical femoral fractures. |
| alternatives | |
| contraindications | Known hypersensitivity to Alendronate. Severe esophageal abnormalities, esophageal stricture, dysphagia. Inability to sit or stand upright for at least 30 minutes after administration. |
| interactions | Concurrent use with antacids, calcium supplements, or iron preparations can significantly reduce absorption. Check for potential interactions with other medications. |
| warnings and precautions | Patient must be instructed to take medication on an empty stomach with a full glass of water and remain upright for at least 30 minutes following administration to reduce esophageal irritation. Monitor for any signs of esophageal problems. Assess for risk factors for ONJ (e.g. concomitant cancer treatments). Monitor for atypical femoral fractures. Evaluate renal function. |
| additional information | Long-term use requires careful monitoring of bone health and potential adverse effects. Individualize treatment and duration. |
