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Alendronate Brand Names- Binosto | Fosamax
What is Alendronate
Alendronate is an oral second-generation bisphosphonate; weekly or daily regimens are available for selected conditions.
Treatment with alendronate is associated with significant increases in bone mineral density (BMD) and reduces the risk for radiographic vertebral and non-vertebral fractures (e.g., hip fractures) in postmenopausal women.
Bisphosphonates such as alendronate are generally considered to be first-line therapy for the treatment of osteoporosis in postmenopausal women.
Bisphosphonates are effective in men with osteoporosis to increase bone density and reduce the risk for vertebral fracture; however, study data are less robust in men regarding reductions in nonvertebral fracture.
For osteoporosis prevention, the second and third-generation bisphosphonates appear to offer similar benefits across the class to increase bone mineral density; the balance of costs, benefits, and harms of treating osteopenic patients with bisphosphonates is most favorable when the estimated risk for fracture is high.
Alendronate is also effective and indicated for osteoporosis in patients receiving chronic corticosteroid treatment.
Alendronate also treats Paget’s disease; guidelines for Paget’s disease include alendronate as an alternative to zoledronic acid for these patients, as alendronate is known to stabilize osteolytic lesions; however, the effect of alendronate may not be as durable as with zoledronic acid and retreatment may be required between 2 and 6 years.
As with other bisphosphonates, alendronate has been investigated for hypercalcemia of malignancy and for adjuvant therapy in selected cancer patients to reduce the risk of osteopenia and related skeletal events; more study is needed.
Alendronate was first FDA-approved in 1995.
Indications & Dosage
- hypercalcemia
- osteoporosis
- osteoporosis prophylaxis
- Paget’s disease
For the treatment of osteoporosis
once-weekly regimen for postmenopausal osteoporosis or osteoporosis in men
Side Effects
- abdominal pain
- alopecia
- angioedema
- arthralgia
- asthenia
- atrial fibrillation
- bone fractures
- bone pain
- conjunctivitis
- constipation
- diarrhea
- dizziness
- dysgeusia
- dyspepsia
- dysphagia
- erythema
- esophageal stricture
- esophageal ulceration
- esophagitis
- fever
- flatulence
- gastritis
- gastroesophageal reflux
- GI bleeding
- GI perforation
- headache
- hypocalcemia
- hypophosphatemia
- lymphopenia
- malaise
- melena
- muscle cramps
- musculoskeletal pain
- myalgia
- nausea
- ocular inflammation
- ocular pain
- oral ulceration
- osteonecrosis
- peptic ulcer
- peripheral edema
- photosensitivity
- pruritus
- pyrosis (heartburn)
- rash
- Stevens-Johnson syndrome
- toxic epidermal necrolysis
- urticaria
- uveitis
- vertigo
- visual impairment
- vomiting
Monitoring Parameters
- serum 25(OH)hydroxyvitamin D concentrations
- serum alkaline phosphatase
- serum calcium
- serum creatinine/BUN
- serum phosphate
Contraindications
- achalasia
- anemia
- breast-feeding
- cardiac disease
- chemotherapy
- children
- coagulopathy
- corticosteroid therapy
- dental disease
- dental work
- dysphagia
- esophageal stricture
- esophagitis
- gastritis
- gastroesophageal reflux disease (GERD)
- geriatric
- GI disease
- GI perforation
- heart failure
- hiatal hernia
- hypertension
- hypocalcemia
- inability to stand or sit upright
- infants
- infection
- neonates
- phosphonate hypersensitivity
- pregnancy
- renal failure
- renal impairment
- sodium restriction
- sunlight (UV) exposure
- vitamin D deficiency
Interactions
- Acetaminophen; Aspirin, ASA; Caffeine
- Aluminum Hydroxide
- Aluminum Hydroxide; Magnesium Carbonate
- Aluminum Hydroxide; Magnesium Hydroxide
- Aluminum Hydroxide; Magnesium Hydroxide; Simethicone
- Aluminum Hydroxide; Magnesium Trisilicate
- Amlodipine; Celecoxib
- Aspirin, ASA
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Caffeine; Orphenadrine
- Aspirin, ASA; Carisoprodol
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Citric Acid; Sodium Bicarbonate
- Aspirin, ASA; Dipyridamole
- Aspirin, ASA; Omeprazole
- Aspirin, ASA; Oxycodone
- Aspirin, ASA; Pravastatin
- Bumetanide
- Calcium
- Calcium Acetate
- Calcium Carbonate
- Calcium Carbonate; Magnesium Hydroxide
- Calcium Carbonate; Risedronate
- Calcium Carbonate; Simethicone
- Calcium Chloride
- Calcium Gluconate
- Calcium; Vitamin D
- Celecoxib
- Chromium
- Deferasirox
- Diclofenac
- Diclofenac; Misoprostol
- Diflunisal
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Esomeprazole; Naproxen
- Ethacrynic Acid
- Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
- Ethinyl Estradiol; Norethindrone; Ferrous fumarate
- Etodolac
- Famotidine; Ibuprofen
- Fenoprofen
- Flurbiprofen
- food
- Furosemide
- H2-blockers
- Hetastarch; Dextrose; Electrolytes
- Hydrocodone; Ibuprofen
- Ibuprofen
- Ibuprofen; Oxycodone
- Ibuprofen; Pseudoephedrine
- Indomethacin
- Iron
- Iron Salts
- Iron Sucrose, Sucroferric Oxyhydroxide
- Ketoprofen
- Ketorolac
- Lansoprazole; Naproxen
- Lanthanum Carbonate
- Levothyroxine
- Levothyroxine; Liothyronine (Porcine)
- Levothyroxine; Liothyronine (Synthetic)
- Loop diuretics
- Magnesium
- Magnesium Citrate
- Magnesium Salts
- Meclofenamate Sodium
- Mefenamic Acid
- Meloxicam
- Nabumetone
- Naproxen
- Naproxen; Pseudoephedrine
- Naproxen; Sumatriptan
- Nonsteroidal antiinflammatory drugs
- Omeprazole; Sodium Bicarbonate
- Oxaprozin
- Parathyroid Hormone
- Piroxicam
- Polycarbophil
- Polysaccharide-Iron Complex
- Proton pump inhibitors
- Rofecoxib
- Sodium Bicarbonate
- Sodium Ferric Gluconate Complex; ferric pyrophosphate citrate
- Sucralfate
- Sulindac
- Tolmetin
- Torsemide
- Valdecoxib
