Alendronate
Synonym :
Alendronic acid
Mechanism :
Alendronic acid reduces bone resorption by inhibiting the action of osteoclasts.
Indication :
- Osteoporosis
- Osteogenesis Imperfecta
- Bone manifestations of Gaucher’s Disease.
Contraindications :
Hypocalcaemia; oesophageal abnormalities and factors which delay oesophageal emptying; severe renal impairment; hypersensitivity; inability to stand or sit upright for atleast 30 min.
Dosing :
Safety and efficacy not established in children. Use in children >2 years orally.
≤30 kg:
5 mg once daily.
30 to <40 kg:
5 or 10 mg once daily.
≥40 kg:
10 mg once daily.
Adverse Effect :
Hypocalcemia (transient and mild), esophagitis, esophageal ulcers and erosions, dysphagia, heartburn, retrosternal pain, abdominal pain, distension, diarrhea, constipation, flatulence, rash, erythema, musculoskeletal pain, transient hypophosphatemia.
Interaction :
Concomitant iron, calcium supplements and antacids hinder alendronate absorption.
Concomitant aspirin or NSAIDs may increase the incidence of adverse GI effects.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
35-50 | Dose as in normal renal function |
<35 | Avoid. |
Dose in Patients undergoing Renal Replacement Therapies
CAPD | Unlikely to be dialysed. Dose as in GFR<35 mL/min |
HD | Not dialysed. Dose as in GFR<35 mL/min |
HDF/High flux | Unknown dialysability. Dose as in GFR<35 mL/min |
CAV/VVHD | Unlikely to be dialysed. Dose as in GFR<35 mL/min |
Hepatic Dose :
No dosage adjustments are recommended.