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Alendronate Disease Interactions

There are 3 disease interactions with alendronate:

Bisphosphonates (Includes Alendronate) ↔ Hypocalcemia

Severe Potential Hazard, High plausibility

Applies to: Hypocalcemia, Vitamin D Deficiency

The use of bisphosphonates is contraindicated for the treatment of osteoporosis in patients with hypocalcemia. These agents increase bone mineral density, a process that requires an adequate supply of calcium in the body. Following the initiation of therapy, a short-term reduction in serum calcium and phosphate levels usually occurs due to inhibition of bone resorption, especially in patients with Paget's disease, in whom the pretreatment rate of bone turnover may be greatly elevated. Hypocalcemia and other disturbances of mineral metabolism, such as vitamin D deficiency, should be treated prior to initiation of therapy. Appropriate intake of calcium and vitamin D should be ensured throughout the course of treatment.

References

  1. Lourwood DL "The pharmacology and therapeutic utility of bisphosphonates." Pharmacotherapy 18 (1998): 779-89
  2. "Product Information. Fosamax (alendronate)." Merck & Co, Inc, West Point, PA.
  3. Schussheim DH, Jacobs TP, Silverberg SJ "Hypocalcemia associated with alendronate." Ann Intern Med 130 (1999): 329
View all 5 references

Bisphosphonates (Includes Alendronate) ↔ Upper Gi Mucosal Irritation

Severe Potential Hazard, High plausibility

Applies to: Dysphagia, Esophageal Disease, Peptic Ulcer, Duodenitis/Gastritis, Dyspepsia

Bisphosphonates may cause local irritation of the upper gastrointestinal mucosa. Esophagitis and esophageal ulcers and erosions, occasionally with bleeding, as well as gastric and duodenal ulcers, have been reported, primarily with alendronate. Because of their structural similarities, therapy with all bisphosphonates should be administered cautiously in patients with active upper gastrointestinal disorders. The usual precautions should be followed closely to minimize the risk of irritation (i.e. taking the medication with a full glass of water after arising for the day and remaining upright for at least 30 minutes afterwards and until the first food intake of the day). Therapy should be discontinued if dysphagia, odynophagia or retrosternal pain occurs. The manufacturer of alendronate considers its use to be contraindicated in patients with abnormalities of the esophagus that may delay esophageal emptying, such as stricture or achalasia.

References

  1. Yue QY, Mortimer O "Alendronate - Risk for esophageal stricture." J Am Geriat Soc 46 (1998): 1581-2
  2. "Product Information. Fosamax (alendronate)." Merck & Co, Inc, West Point, PA.
  3. Rimmer DE, Rawls DE "Improper alendronate administration and a case of pill esophagitis." Am J Gastroenterol 91 (1996): 2648-9
View all 17 references

Alendronate (Includes Alendronate) ↔ Renal Dysfunction

Moderate Potential Hazard, Moderate plausibility

Applies to: Renal Dysfunction

Alendronate is primarily eliminated by the kidney. In healthy controls, drug that is not deposited in bone is rapidly excreted in the urine. Although clinical information is not available, animal studies suggest reduced drug clearance in renal failure. Alendronate is not recommended for use in patients with creatinine clearance less than 35 mL/min due to a lack of clinical experience in this setting. No dosage adjustment is necessary in patients with mild to moderate renal impairment (CrCl >= 35 mL/min).

References

  1. "Product Information. Fosamax (alendronate)." Merck & Co, Inc, West Point, PA.

You should also know about...

alendronate drug Interactions

There are 204 drug interactions with alendronate

alendronate alcohol/food Interactions

There are 2 alcohol/food interactions with alendronate

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. Multum's information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2014 Multum Information Services, Inc. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.

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