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Actonel with Calcium Side Effects

Generic name: calcium carbonate / risedronate

Medically reviewed by Last updated on Mar 22, 2024.

Note: This document contains side effect information about calcium carbonate / risedronate. Some dosage forms listed on this page may not apply to the brand name Actonel with Calcium.

Applies to calcium carbonate / risedronate: oral kit.


You should not use this medicine if you have low levels of calcium in your blood (hypocalcemia), or a problem with the movement of muscles in your esophagus.

Do not take a calcium carbonate and risedronate tablet if you cannot sit upright or stand for at least 30 minutes. Risedronate can cause serious problems in the stomach or esophagus (the tube that connects your mouth and stomach).

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

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

Common side effects may include:

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

For Healthcare Professionals

Applies to calcium carbonate / risedronate: oral kit.


Cardiovascular side effects of risedronate have included hypertension, cardiovascular disorders, and angina pectoris.[Ref]


Dermatologic side effects of risedronate have included rash, pruritus, and skin cancer.[Ref]


Gastrointestinal side effects of risedronate have included diarrhea, nausea, flatulence, gastrointestinal disorder, constipation, rectal disorder and tooth disorder.

Gastrointestinal side effects of calcium carbonate have included rebound hyperacidity, constipation (6% to 37%) and gallstones (rarely).[Ref]

During phase 3 clinical studies of risedronate, patients with a history of upper gastrointestinal (GI) disease or abnormalities were not excluded. Severe upper GI side effects were not noted. Patients using NSAIDs or aspirin were also included in phase 3 clinical studies. GI side effects in patient using concomitant NSAIDs or aspirin were higher than in non users.

Rebound hyperacidity has been associated with calcium salt antacids. This side effect does not appear to be due to the acid buffering capacity of calcium carbonate, but is a consequence of a specific action of calcium on the parietal cell. Rare cases of calcium carbonate gallstones have been reported in the pediatric literature.[Ref]


General body side effects of risedronate have included infection, back pain, pain, abdominal pain, chest pain, hernia, otitis media, and asthenia.[Ref]


Hypersensitivity side effects of risedronate have included angioedema, generalized rash, and bullous skin reactions.[Ref]


There were no deaths in a 1 year, double-blind, placebo-controlled study of risedronate 35 mg once a week for prevention of bone loss in 278 postmenopausal women without osteoporosis. More treated subjects on risedronate experienced arthralgia (risedronate 13.9%; placebo 7.8%), myalgia (risedronate 5.1%; placebo 2.1%), and nausea (risedronate 7.3%; placebo 4.3%) than subjects on placebo.[Ref]

Musculoskeletal side effects of risedronate have included arthralgias, bone pain, joint disorder, myalgia, bone pain, bone disorder, bursitis, hypertonia, tendon disorder, and leg cramps.[Ref]

Nervous system

Nervous system side effects of risedronate have included headache, dizziness, depression, insomnia, anxiety, neuralgia, vertigo, hypertonia, paresthesia and tinnitus.[Ref]


Ocular side effects have of risedronate included cataracts and conjunctivitis.[Ref]

Iritis occurred in 3 patients in one supportive study. Treatment with topical steroids was effective in all cases. Iritis has not been observed in other clinical studies.[Ref]


Oncologic side effects of risedronate have included neoplasms which have occurred in 3% of patients receiving risedronate therapy.[Ref]


Respiratory side effects of risedronate have included bronchitis and sinusitis. Postmarketing side effects have included exacerbations of asthma.[Ref]


Metabolic side effects of calcium carbonate have rarely included hypercalcemia and hypophosphatemia. Other metabolic side effects have rarely included "mild alkali syndrome", calcinosis, and irreversible renal damage.[Ref]

Prolonged ingestion of large amounts of calcium carbonate and other sources of exogenous calcium can rarely result in the "milk alkali syndrome" and calcinosis. The milk alkali syndrome is characterized by the triad of hypercalcemia, metabolic alkalosis, and renal insufficiency.[Ref]


Genitourinary side effects of risedronate have included urinary tract infection and cystitis.[Ref]


Hematologic side effects of risedronate have included ecchymosis and anemia.[Ref]


Renal side effects of calcium carbonate have included renal failure, formation of renal calcium, and a single case report of a calcium carbonate and calcium phosphate-filled renal cyst.[Ref]

The renal failure that accompanies hypercalcemia and alkalosis in the milk alkali syndrome is usually transient.[Ref]

More about Actonel with Calcium (calcium carbonate / risedronate)

Patient resources

Other formulations

Related treatment guides


1. "Multum Information Services, Inc. Expert Review Panel"

Further information

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

Some side effects may not be reported. You may report them to the FDA.