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Actonel

Generic Name: risedronate (rih SED ro nayt)
Brand Names: Actonel, Atelvia

Medically reviewed on September 13, 2018

What is Actonel?

Actonel (risedronate) is a bisphosphonate medicine that alters bone formation and breakdown in the body. This can slow bone loss and may help prevent bone fractures.

Actonel is used to treat or prevent osteoporosis caused by menopause, steroid use, or gonadal failure.

Actonel is also used to increase bone mass in men who have osteoporosis, and to treat Paget's disease of bone in men and women.

Important information

You should not take Actonel if you have problems with your esophagus, or low levels of calcium in your blood.

Do not take Actonel if you cannot sit upright or stand for at least 30 minutes after taking the medicine.

Risedronate can cause serious problems in the stomach or esophagus. Stop using Actonel and call your doctor at once if you have chest pain, new or worsening heartburn, or pain when swallowing.

Also call your doctor if you have muscle spasms, numbness or tingling (in hands and feet or around the mouth), new or unusual hip pain, or severe pain in your joints, bones, or muscles.

Actonel side effects

Get emergency medical help if you have signs of an allergic reaction to Actonel (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, red or purple skin rash that spreads and causes blistering and peeling).

Stop using Actonel and call your doctor at once if you have:

  • chest pain, new or worsening heartburn;

  • difficulty or pain when swallowing;

  • pain or burning under the ribs or in the back;

  • severe heartburn, burning pain in your upper stomach, or coughing up blood;

  • new or unusual pain in your thigh or hip;

  • jaw pain, numbness, or swelling;

  • severe joint, bone, or muscle pain; or

  • low calcium levels - muscle spasms or contractions, numbness or tingly feeling (around your mouth, or in your fingers and toes).

Common Actonel side effects may include:

  • heartburn, indigestion;

  • stomach pain, diarrhea;

  • back pain, joint pain, muscle pain; or

  • flu-like symptoms.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Before taking this medicine

You should not take Actonel if you are allergic to risedronate, or if you have:

  • low levels of calcium in your blood (hypocalcemia); or

  • problems with the muscles in your esophagus (the tube that connects your mouth and stomach).

Do not take Actonel if you cannot sit upright or stand for at least 30 minutes. Risedronate can cause serious problems in the stomach or esophagus. You must stay upright for at least 30 minutes after taking this medicine.

To make sure Actonel is safe for you, tell your doctor if you have ever had:

  • trouble swallowing;

  • problems with your stomach or digestion;

  • hypocalcemia;

  • a dental problem (you may need a dental exam before you begin taking risedronate);

  • kidney disease; or

  • any condition that makes it hard for your body to absorb nutrients from food (malabsorption).

In rare cases, this medicine may cause bone loss (osteonecrosis) in the jaw. Symptoms include jaw pain or numbness, red or swollen gums, loose teeth, or slow healing after dental work. The longer you use risedronate, the more likely you are to develop this condition.

Osteonecrosis of the jaw may be more likely if you have cancer or received chemotherapy, radiation, or steroids. Other risk factors include blood clotting disorders, anemia (low red blood cells), and a pre existing dental problem.

Talk with your doctor about the risks and benefits of using this medication.

It is not known whether Actonel will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether risedronate passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

How should I take Actonel?

Actonel tablets come in different strengths (number of milligrams per pill) that are taken on different schedules. You may need to take a tablet once per day, once per week, once per month, or for 2 days in a row once per month.

Your dosing schedule will depend on why you are taking Actonel and in what tablet strength. If you change strengths, you may also need to change your schedule.

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Take the Actonel tablet first thing in the morning with a full glass (6 to 8 ounces) of water, at least 30 minutes before you eat or drink anything or take any other medicine.

Use only plain water when taking a Actonel tablet. Do not use coffee, tea, soda, juice, or mineral water.

Do not crush, chew, or suck on a tablet. Swallow the tablet whole.

After swallowing Actonel tablet, wait at least 30 minutes:

  • Before you lie down or recline. You may sit, stand or walk, and do normal activities like reading.

  • Before you take your first food or drink except for plain water.

  • Before you take other medicines including vitamins, calcium, iron, antacids, or laxatives.

Take this medicine at the same time each day or on the same day each week or each month (depending on your dosing schedule).

Pay special attention to your dental hygiene while taking risedronate. Brush and floss your teeth regularly. If you need to have any dental work (especially surgery), tell the dentist ahead of time that you are using risedronate.

Actonel is only part of a complete program of treatment that may also include diet changes, exercise, bone mineral density testing, and taking calcium and vitamin supplements. Follow your doctor's instructions very closely.

Store at room temperature away from moisture and heat. Keep unused effervescent tablets in the foil blister pack.

Your doctor will determine how long to treat you with this medicine. Actonel is often given for only 3 to 5 years.

Actonel dosing information

Usual Adult Dose of Actonel for Osteoporosis:

Treatment of Postmenopausal Osteoporosis:
Immediate release:
-5 mg orally once a day or
-35 mg orally once a week or
-75 mg orally on two consecutive days for a total of two tablets each month or
-150 mg orally once a month
Delayed release:
-35 mg orally once a week

Treatment to Increase Bone Mass in Men with Osteoporosis:
Immediate release:
-35 mg orally once a week

Treatment of Glucocorticoid-Induced Osteoporosis:
Immediate release:
-5 mg orally once a day

Comments:
-Refer to administration advice for details on how to take this drug.
-Reevaluate bisphosphonate therapy periodically.
-Patients treated with glucocorticoids should receive adequate amounts of calcium and vitamin D.

Uses:
-Treatment to reduce the incidence of vertebral fractures and composite endpoint of nonvertebral osteoporosis-related fractures in postmenopausal women
-Treatment to increase bone mass in men with osteoporosis
-Treatment of glucocorticoid-induced osteoporosis in men and women who are either initiating or continuing systemic glucocorticoid treatment (daily dosage of greater than or equal to 7.5 mg of prednisone or equivalent) for chronic diseases

Usual Adult Dose for Prevention of Osteoporosis:

Prevention of Postmenopausal Osteoporosis:
-5 mg orally once a day or
-35 mg orally once a week or
-75 mg orally on two consecutive days for a total of two tablets each month or
-150 mg orally once a month

Prevention of Glucocorticoid-Induced Osteoporosis:
-5 mg orally once a week

Comments:
-Refer to administration advice for details on how to take this drug.
-Reevaluate bisphosphonate therapy periodically.
-Patients treated with glucocorticoids should receive adequate amounts of calcium and vitamin D.

Uses:
-Prevention of osteoporosis in postmenopausal women
-Prevention of glucocorticoid-induced osteoporosis in men and women who are either initiating or continuing systemic glucocorticoid treatment (daily dosage of greater than or equal to 7.5 mg of prednisone or equivalent) for chronic diseases

Usual Adult Dose of Actonel for Paget's Disease:

-30 mg orally once a day for 2 months

Comments:
-Retreatment may be considered (following post-treatment observation of at least 2 months) if relapse occurs, or if treatment fails to normalize serum alkaline phosphatase.
-For retreatment, the dose and duration of therapy are the same as for initial treatment.
-There is no data available on more than 1 course of retreatment.

Use: Treatment of Paget's disease of bone in men and women

See also: Dosage Information (in more detail)

What happens if I miss a dose?

Once-daily dosing: If you forget to take Actonel first thing in the morning, do not take it later in the day. Wait until the following morning and skip the missed dose. Do not take two (2) doses in one day.

Once-per-week or once-per-month dosing: If you forget to take Actonel on your scheduled day, take it first thing in the morning on the day after you remember the missed dose. Then return to your regular weekly or monthly schedule on your chosen dose day. Do not take 2 doses in one day.

What happens if I miss a dose?

Once-daily dosing: If you forget to take Actonel first thing in the morning, do not take it later in the day. Wait until the following morning and skip the missed dose. Do not take two (2) doses in one day.

Once-per-week or once-per-month dosing: If you forget to take Actonel on your scheduled day, take it first thing in the morning on the day after you remember the missed dose. Then return to your regular weekly or monthly schedule on your chosen dose day. Do not take 2 doses in one day.

What happens if I overdose?

Drink a full glass of milk and seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Do not make yourself vomit and do not lie down.

What should I avoid while taking Actonel?

Do not take two different brands or strengths of risedronate at the same time.

Avoid taking any other medicines for at least 30 minutes after taking Actonel. This includes vitamins, calcium, iron, antacids, or laxatives. Some medicines can make it harder for your body to absorb risedronate.

Avoid smoking, or try to quit. Smoking can reduce your bone mineral density, making fractures more likely.

Avoid drinking large amounts of alcohol. Heavy drinking can also cause bone loss.

What other drugs will affect Actonel?

Tell your doctor about all your current medicines and any you start or stop using, especially:

  • aspirin;

  • iron supplements;

  • antacids, laxatives; or

  • NSAIDs (nonsteroidal anti-inflammatory drugs) - ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

This list is not complete. Other drugs may interact with risedronate, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. Talk with your doctor about the best dosing schedule for your other medicines.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Actonel only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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