Trade Names:Fosamax Plus D- Tablets alendronate 70 mg/cholecalciferol 70 mcg- Tablets alendronate 70 mg/cholecalciferol 140 mcg
Fosavance (Canada)Inhibits bone resorption and increases bone density.
Treatment of osteoporosis in postmenopausal women; treatment to increase bone mass in men with osteoporosis.
Abnormalities of the esophagus that delay esophageal emptying (eg, achalasia, stricture); inability to stand or sit upright for at least 30 min; hypocalcemia; hypersensitivity to any component of the product.
PO One 70 mg/70 mcg tablet once weekly or one 70 mg/140 mcg tablet once weekly.
Store at 59° to 89°F. Protect from moisture and light.
Alendronate absorption may be reduced; take alendronate at least 30 min before other medications.
Anticonvulsants, cimetidine, thiazidesMay increase cholecalciferol catabolism.
AspirinIncidence of upper GI adverse reactions may be increased in patients taking more than 10 mg of alendronate daily.
Bile acid sequestrants (eg, cholestyramine, colestipol), mineral oil, Olestra, orlistatMay impair cholecalciferol absorption.
NSAIDsUse with caution because of potential GI irritation.
None well documented.
Headache (3%); asthenia, dizziness, malaise, vertigo (postmarketing).
Photosensitivity, pruritus, rash, Stevens-Johnson syndrome, toxic epidermal necrolysis (postmarketing).
Episcleritis, scleritis, uveitis (postmarketing).
Abdominal pain (7%); dyspepsia, nausea (4%); constipation, diarrhea, flatulence, gastroesophageal reflux disease (3%); esophageal ulcer (2%); abdominal distention, dysphagia, vomiting (1%); duodenal ulcers, esophageal erosions, esophageal perforation or stricture, esophageal ulcers, esophagitis, gastric ulcers, oropharyngeal ulceration (postmarketing).
Mild, transient decreases in serum calcium (18%) and phosphate (10%); symptomatic hypocalcemia (postmarketing).
Bone, muscle, or joint pain (4%); joint swelling, myalgia (postmarketing).
Fever, hypersensitivity (including urticaria and angioedema), localized osteonecrosis of the jaw often associated with tooth extraction and/or local infection with delayed healing, peripheral edema (postmarketing).
Category C .
Undetermined.
CholecalciferolExcreted in breast milk.
Not indicated for use in children.
No overall differences in efficacy or safety between patients 65 years of age and older compared with younger patients.
Not recommended in severe renal function impairment (CrCl less than 35 mL/min).
Use with caution in patients with upper GI problems (eg, duodenitis, dysphagia, esophageal disease, gastritis, ulcers).
Correct before starting treatment.
Severe and occasionally incapacitating bone, joint, and/or muscle pain has been reported 1 day to several months after starting bisphosphonates.
Patients at increased risk of vitamin D deficiency should receive vitamin D supplementation.
Has been reported with bisphosphonates. Risk factors include cancer, concomitant therapies (eg, chemotherapy, corticosteroids, or radiotherapy), poor oral hygiene, and comorbid disorders (eg, anemia, coagulopathy, dental disease, infection).
Anorexia, hypercalcemia, hypercalciuria, hypocalcemia, hypophosphatemia, lethargy, nausea, polydipsia, polyuria, upper GI adverse reactions (eg, esophagitis, gastritis, heartburn, ulcer, upset stomach), vomiting, weakness.
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