Alendronate and Cholecalciferol Brand Name– Fosamax Plus D
What is Alendronate and Cholecalciferol
Alendronate and cholecalciferol is a combination product used once per week to increase bone mass and treat osteoporosis in both men and postmenopausal women.
Alendronate is a second-generation bisphosphonate, and such bisphosphonates 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.
While alendronate is useful for the treatment of other conditions, the fixed dosage regimen of the alendronate; cholecalciferol product is only for treatment of osteoporosis.
Cholecalciferol (vitamin D3) is one of the two primary forms of vitamin D. Cholecalciferol is the natural precursor of 1,25 dihydroxyvitamin D3, which is a calcium-regulating hormone. Increased serum 25-hydroxyvitamin D3 concentrations have been associated with decreased serum parathyroid hormone concentrations, which have been associated with increased bone mineral density.
Alendronate; cholecalciferol once-weekly tablets help provide the equivalent of 7 days’ worth of either 10 or 20 mcg (400 or 800 International Units) vitamin D per day to help meet recommended dietary intakes based on age.
As with other bisphosphonate products, supplement the patient’s calcium if dietary intake is inadequate and some patients may need additional vitamin D to provide adequate intake for their condition(s).
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
- hyperphosphatemia
- hypervitaminosis D
- hypocalcemia
- hypophosphatemia
- malaise
- musculoskeletal pain
- myalgia
- nausea
- ocular inflammation
- ocular pain
- oral ulceration
- osteonecrosis
- peptic ulcer
- peripheral edema
- photosensitivity
- pruritus
- 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
- chemotherapy
- children
- coagulopathy
- corticosteroid therapy
- dental disease
- dental work
- dysphagia
- esophageal stricture
- esophagitis
- gastritis
- gastroesophageal reflux disease (GERD)
- geriatric
- GI disease
- GI perforation
- hiatal hernia
- hypercalcemia
- hyperphosphatemia
- hypervitaminosis D
- hypocalcemia
- hypoparathyroidism
- inability to stand or sit upright
- infection
- lactase deficiency
- leukemia
- lymphoma
- malabsorption syndrome
- nephrolithiasis
- phosphonate hypersensitivity
- pregnancy
- renal failure
- renal impairment
- sarcoidosis
- 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
- Castor Oil
- Celecoxib
- Cholestyramine
- Chromium
- Colesevelam
- Colestipol
- 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
- Hydantoins
- Hydrocodone; Ibuprofen
- Ibuprofen
- Ibuprofen; Oxycodone
- Ibuprofen; Pseudoephedrine
- Indomethacin
- Iron
- Iron Salts
- Iron Sucrose, Sucroferric Oxyhydroxide
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Ketoprofen
- Ketorolac
- Lansoprazole; Naproxen
- Lanthanum Carbonate
- Levothyroxine
- Levothyroxine; Liothyronine (Porcine)
- Levothyroxine; Liothyronine (Synthetic)
- Loop diuretics
- Magnesium
- Magnesium Citrate
- Magnesium Hydroxide
- Magnesium Salts
- Meclofenamate Sodium
- Mefenamic Acid
- Meloxicam
- Mineral Oil
- Nabumetone
- Naproxen
- Naproxen; Pseudoephedrine
- Naproxen; Sumatriptan
- Nonsteroidal antiinflammatory drugs
- Omeprazole; Sodium Bicarbonate
- Orlistat
- Oxaprozin
- Parathyroid Hormone
- Phosphorus
- Piroxicam
- Polycarbophil
- Polysaccharide-Iron Complex
- Proton pump inhibitors
- Rifampin
- Rofecoxib
- Sodium Bicarbonate
- Sodium Ferric Gluconate Complex; ferric pyrophosphate citrate
- Sucralfate
- Sulindac
- Thiazide diuretics
- Tolmetin
- Torsemide
- Valdecoxib
