Alendronate and Cholecalciferol

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

  1. abdominal pain
  2. alopecia
  3. angioedema
  4. arthralgia
  5. asthenia
  6. atrial fibrillation
  7. bone fractures
  8. bone pain
  9. conjunctivitis
  10. constipation
  11. diarrhea
  12. dizziness
  13. dysgeusia
  14. dyspepsia
  15. dysphagia
  16. erythema
  17. esophageal stricture
  18. esophageal ulceration
  19. esophagitis
  20. fever
  21. flatulence
  22. gastritis
  23. gastroesophageal reflux
  24. GI bleeding
  25. GI perforation
  26. hyperphosphatemia
  27. hypervitaminosis D
  28. hypocalcemia
  29. hypophosphatemia
  30. malaise
  31. musculoskeletal pain
  32. myalgia
  33. nausea
  34. ocular inflammation
  35. ocular pain
  36. oral ulceration
  37. osteonecrosis
  38. peptic ulcer
  39. peripheral edema
  40. photosensitivity
  41. pruritus
  42. rash
  43. Stevens-Johnson syndrome
  44. toxic epidermal necrolysis
  45. urticaria
  46. uveitis
  47. vertigo
  48. visual impairment
  49. 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
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