Risedronate

Risedronate is a prescription medication used to treat conditions in which bones become weak and break easily such as osteoporosis and Paget's disease.

Risedronate belongs to a group of drugs called bisphosphonates that work by preventing bone breakdown and increasing bone density. 

The medication comes in the form of a tablet and a delayed-release tablet. Depending on which form you take as well as other factors, risedronate is taken daily, weekly, or monthly.

Common side effects include back and joint pain, stomach area (abdominal) pain, and heartburn. Risedronate can cause esophagus (tube connecting the throat to the stomach) problems and low calcium levels in your blood (hypocalcemia).

Risedronate is a prescription medicine that is used:

•  to prevent and treat osteoporosis in postmenopausal women (women that have gone through the "end of periods" or "change of life")
•  to increase bone mass in men with osteoporosis (a condition in which bones weaken and break easily)
•  to prevent and treat osteoporosis in men and women that is caused by treatment with steroid medicines such as prednisone
•  to treat Paget’s disease (a condition in which bones are soft, weak, deformed, painful, or easily broken) of bone in men and women

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Risedronate may be found in some form under the following brand names:

• Actonel

• Atelvia

Risedronate may cause serious side effects. See “Drug Precautions”.

The most common side effects of risedronate are:

• pain, including back and joint pain
• stomach area (abdominal) pain
• heartburn

Risedronate can cause allergic reactions, such as hives or, in rare cases, swelling of your face, lips, tongue, or throat.

Tell your doctor if you have any side effect that is severe, or does not go away.

This is not a complete list of Risedronate side effects. Ask your doctor or pharmacist for more information.

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins and herbal supplements. Especially tell your doctor if you take:

• NSAIDS (nonsteroidal anti-inflammatory drugs) such as ibuprofen (Motrin, Advil), naproxen (Aleve, Naprosyn)
• aspirin
• antacids
• proton pump inhibitors such as esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix),
• H2 blockers such as cimetidine (Tagamet), famotidine (Pepcid), nizatidine (Axid), ranitidine (Zantac)
• hormone therapy such as estrogens and estrogen agonist/blockers
• cancer chemotherapy treatments
• steroids such as dexamethasone (Decadron), methylprednisolone (Medrol) and prednisone (Deltasone)

The following medicines can lower the amount of risedronate that your body absorbs:

• antacids
• calcium supplements
• aluminum supplements
• magnesium supplements
• aspirin
• iron supplements

If you must take these medicines, wait at least 30 minutes after taking risedronate.

1. Risedronate can cause esophagus (tube connecting the throat to the stomach) problems. It is important that you take risedronate exactly as prescribed to help lower your chance of getting esophagus problems including:

• irritation
• inflammation
• ulcers of the esophagus which may sometimes bleed

Stop taking risedronate and call your doctor right away if you have painful or difficult swallowing, chest pain,  or new or worsening heartburn.

2. Risedronate can cause low calcium levels in your blood (hypocalcemia), which can worsen already low blood calcium conditions. If you have low blood calcium before taking Risedronate it must be treated before you take risedronate. You may not know you have low blood calcium, but some people may have the following symptoms:

• Spasms, twitches, or cramps in your muscles
• Numbness or tingling in your fingers, toes, or around your mouth

Your doctor may prescribe calcium and vitamin D to help prevent low calcium levels in your blood, while you take risedronate. Take calcium and vitamin D as your doctor tells you to.

3. Severe jaw bone problems may happen when you take risedronate. Your doctor and dentist may examine your mouth before you start risedronate. 

4. Some people who take risedronate develop severe bone, joint, or muscle pain.

5. Some people have developed unusual fractures in their thigh bone. Symptoms of a fracture may include new or unusual pain in your hip, groin, or thigh.

Call your doctor right away if you have any of these side effects.

Do not take risedronate if you:

• have certain problems with your esophagus, the tube that connects your mouth with your stomach
• cannot stand or sit upright for at least 30 minutes
• have low levels of calcium in your blood
• are allergic to risedronate any of its ingredients

Foods and some vitamin supplements and medicines can stop your body from absorbing (using) risedronate. Therefore, do not take anything other than plain water at or near the time you take risedronate and for 30 minutes after.

Before you receive risedronate, tell you doctor about all the medical conditions you have including if you have:

• swallowing problems
• stomach or digestive problems
• low blood calcium
• plans to have dental surgery or teeth removed
• kidney problems
• trouble absorbing minerals in your stomach or intestines (malabsorption syndrome)

Tell your doctor if you are pregnant or breastfeeding.

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins and herbal supplements. 

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Risedronate falls into category C. In animal studies, pregnant animals were given this medication and had some babies born with problems. No well-controlled studies have been done in humans. Therefore, this medication may be used if the potential benefits to the mother outweigh the potential risks to the unborn child.

Tell your doctor before using risedronate if you are breastfeeding or plan to breastfeed. It is not known if risedronate is excreted in human breast milk or if it can harm your baby.

Take risedronate exactly as prescribed by your healthcare provider.

Risedronate tablets

• Take risedronate exactly as prescribed by your healthcare provider.
• Take risedronate first thing in the morning before you eat or drink anything except plain water.
• Take risedronate while you are sitting up or standing.
• Take risedronate with 6 to 8 ounces (about 1 cup) of plain water. Do not take it with any other drink besides plain water. Do not eat or drink anything for 30 minutes after taking risedronate.
• Swallow risedronate whole. Do not chew the tablet or keep it in your mouth to melt or dissolve it.

After taking risedronate you must wait at least 30 minutes before:

• lying down. You may sit, stand, or do normal activities like read the newspaper or take a walk.
• eating or drinking anything except plain water.
• taking vitamins, calcium, or antacids. It is best to take vitamins, calcium, and antacids at a different time of the day from when you take risedronate.

If you miss a dose of risedronate, do not take it later in the day. Take your missed dose the next morning and then return to your normal schedule. Do not take 2 doses at the same time.

Risedronate delayed release tablets

• Take risedronate delayed release tablets in the morning immediately following breakfast. Risedronate delayed release tablets should be taken immediately following breakfast and not under fasting conditions because of a higher risk of abdominal pain if taken before breakfast when fasting.
• Swallow tablets whole while in an upright position and with at least 4 ounces of plain water to facilitate delivery to the stomach.
• Avoid lying down for 30 minutes after taking the medication.
• Do not chew, cut, or crush risedronate delayed release tablets tablets. Swallow tablets whole.
• If you cannot swallow tablets whole, tell your doctor. You may need a different medicine.

If you miss more than 2 doses of risedronate in a month, call your doctor for instructions.

If you take too much risedronate, call your doctor. Do not try to vomit. Do not lie down.

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

Treatment of Postmenopausal Osteoporosis

• 5 mg daily in the morning.
• 35 mg weekly in the morning.
• 75 mg in the morning two days in a row every month (150 mg once a month).

Prevention of Postmenopausal Osteoporosis

• 5 mg daily in the morning.
• 35 mg weekly in the morning.

Treatment to Increase Bone Mass in Men with Osteoporosis

• 35 mg weekly in the morning.

Glucocorticoid-Induced Osteoporosis

• 5 mg daily in the morning.

Treatment of Paget's Disease

• 30 mg daily for 2 months. Retreatment may be considered if relapse occurs, or if treatment fails to normalize serum alkaline phosphatase.

If you take too much risedronate (overdose) take a full glass of milk and call your local Poison Control Center or seek emergency medical attention right away.

• Store risedronate at room temperature, 68° F to 77° F (20° C to 25° C).
• Safely throw away medicine that is out of date or no longer needed.
• Keep risedronate and all medicines out of the reach of children.