Description

Simple

A medication used to prevent and treat bone loss (typically caused by osteoporosis).

Clinical

A bisphosphonate drug that prevents osteoclastic bone resorption and is used for the prevention and treatment of osteoporosis.

Overview

Alendronic acid is a bisphosphonate that is used for the treatment of some forms of osteoperosis and Paget's disease[FDA Label][1]. It functions by preventing resorption of bone[FDA Label][1].

Pharmacology

Indication

Alendronic acid is indicated for the treatment and prevention of osteoporosis in men and postmenopausal women, treatment of glucocorticoid-induced osteoporosis, and Paget's disease of bone[FDA Label][ Read more

Pharmacodynamic

Alendronic acid tablets have a very low oral bioavialability[FDA Label][2]. After adminis... Read more

Mechanism of action

Alendronic acid binds to bone hydroxyapatite[FDA Label]. Bone resorption causes local acidification, releasing alendronic acid which is that taken into osteoclasts by fluid-phase endocytosis[ Read more

Absorption

Mean oral bioavailability of alendronic acid in women is 0.64% and in men is 0.59%[FDA Label][ Read more

Protein binding

78%[FDA Label]. Studies in rats show that plasma protein binding increases with decreasing alendronic acid plasma concentration[ Read more

Volume of distribution

28L[FDA Label].

Clearance

71mL/min[FDA Label].

Half life

Due to alendronic acid being incorporated into the skeleton, the terminal half life is estimated to be over 10 years[FDA Label].

Route of elimination

Administration of radiolabeled alendronic acid results in 50% recovery in urine within 72 hours[FDA Label][ Read more

Toxicity

In clinical studies, ≥3% of patients experience abdominal pain, acid regurgitation, constipation, diarrhea, dyspepsia, musculoskeletal pain, and nausea[FDA Label].

No information for treatment of overdose is available, however patients should be given milk or antacids to bind alendronic acid and... Read more

Adverse Effects

Contraindications

  • Route:
    • Oral
  • Dose Form:
    • Tablet
  • Sex Group: all
  • Regions: US
  • Patient Conditions:
      • Name: Inability to stand or sit upright for at least 30 minutes
      • Drugbank Id: DBCOND0118757
  • Route:
    • Oral
  • Dose Form:
    • Tablet
  • Sex Group: all
  • Regions: US
  • Patient Conditions:
      • Name: Achalasia
      • Drugbank Id: DBCOND0032922
  • Route:
    • Oral
  • Dose Form:
    • Tablet
  • Sex Group: all
  • Regions: US
  • Patient Conditions:
      • Name: Stricture
      • Drugbank Id: DBCOND0057158
  • Route:
    • Oral
  • Dose Form:
    • Tablet
  • Sex Group: all
  • Regions: US
  • Patient Conditions:
      • Name: Abnormalities of the esophagus
      • Drugbank Id: DBCOND0108189
  • Route:
    • Oral
  • Dose Form:
    • Tablet
  • Sex Group: all
  • Regions: US
  • Patient Conditions:
      • Name: Aspiration
      • Drugbank Id: DBCOND0019548
  • Route:
    • Oral
  • Dose Form:
    • Tablet
  • Hypersensitivity:
    • true
  • Sex Group: all
  • Regions: US
  • Regions: US
  • Patient Conditions:
      • Name: Hypocalcemia
      • Drugbank Id: DBCOND0020582

Food Interactions

  • Take 30-60 minutes before breakfast.
  • Take with a full glass of water.

Interactions

Type in a drug name to check for interaction with Alendronic acid
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  • Paracetamol(acetaminophen)
  • Paxil(paroxetine)
  • Pamelor(nortriptyline)
  • Panadol(acetaminophen)
  • Patanol(olopatadine ophthalmic)
  • Pataday(olopatadine ophthalmic)
  • Parnate(tranylcypromine)
  • Pazeo(olopatadine ophthalmic)
Aceclofenac
The risk or severity of adverse effects can be increased when Aceclofenac is combined with Alendronic acid.
Acemetacin
The risk or severity of adverse effects can be increased when Acemetacin is combined with Alendronic acid.
Acetylsalicylic acid
The risk or severity of adverse effects can be increased when Acetylsalicylic acid is combined with Alendronic acid.
Acipimox
The risk or severity of myopathy, rhabdomyolysis, and myoglobinuria can be increased when Alendronic acid is combined with Acipimox.
Acyclovir
The risk or severity of nephrotoxicity and hypocalcemia can be increased when Acyclovir is combined with Alendronic acid.
Adefovir
The risk or severity of nephrotoxicity and hypocalcemia can be increased when Adefovir is combined with Alendronic acid.
Adefovir dipivoxil
The risk or severity of nephrotoxicity and hypocalcemia can be increased when Adefovir dipivoxil is combined with Alendronic acid.
Alclofenac
The risk or severity of adverse effects can be increased when Alclofenac is combined with Alendronic acid.
Almasilate
The serum concentration of Alendronic acid can be decreased when it is combined with Almasilate.
Alminoprofen
The risk or severity of adverse effects can be increased when Alminoprofen is combined with Alendronic acid.
Aloglutamol
The serum concentration of Alendronic acid can be decreased when it is combined with Aloglutamol.
Aluminium
The serum concentration of Alendronic acid can be decreased when it is combined with Aluminium.
Aluminium acetoacetate
The serum concentration of Alendronic acid can be decreased when it is combined with Aluminium acetoacetate.
Aluminium clofibrate
The risk or severity of myopathy, rhabdomyolysis, and myoglobinuria can be increased when Alendronic acid is combined with Aluminium clofibrate.
Aluminium glycinate
The serum concentration of Alendronic acid can be decreased when it is combined with Aluminium glycinate.
Aluminium phosphate
The serum concentration of Alendronic acid can be decreased when it is combined with Aluminium phosphate.
Aluminum hydroxide
The serum concentration of Alendronic acid can be decreased when it is combined with Aluminum hydroxide.
Amikacin
The risk or severity of nephrotoxicity and hypocalcemia can be increased when Amikacin is combined with Alendronic acid.
Aminophenazone
The risk or severity of adverse effects can be increased when Aminophenazone is combined with Alendronic acid.
Amiodarone
The risk or severity of myopathy, rhabdomyolysis, and myoglobinuria can be increased when Alendronic acid is combined with Amiodarone.
4 References
  1. 1 . Russell RG, Watts NB, Ebetino FH, Rogers MJ: Mechanisms of action of bisphosphonates: similarities and differences and their potential influence on clinical efficacy. Osteoporos Int. 2008 Jun;19(6):733-59. doi: 10.1007/s00198-007-0540-8.PubMed: 18214569
  2. 2 . Porras AG, Holland SD, Gertz BJ: Pharmacokinetics of alendronate. Clin Pharmacokinet. 1999 May;36(5):315-28. doi: 10.2165/00003088-199936050-00002.PubMed: 10384857
  3. 3 . Lin JH, Chen IW, Deluna FA, Hichens M: Renal handling of alendronate in rats. An uncharacterized renal transport system. Drug Metab Dispos. 1992 Jul-Aug;20(4):608-13.PubMed: 1356743
  4. 4 . Lin JH, Chen IW, deLuna FA, Hichens M: Role of calcium in plasma protein binding and renal handling of alendronate in hypo- and hypercalcemic rats. J Pharmacol Exp Ther. 1993 Nov;267(2):670-5.PubMed: 8246140