Alendronate (brand name, Fosamax) is manufactured by Merck & Co., Inc. of Whitehouse Station, New Jersey, and has been approved by the U.S. Food and Drug Administration to treat and prevent osteoporosis in postmenopausal women, to increase bone mass in men with osteoporosis, to treat glucocorticoid-induced osteoporosis in men and women and to treat Paget's disease in men and women. Alendronate is also available with vitamin D (cholecalciferol) under the brand name Fosamax plus D.
Significance
Osteoporosis affects millions of Americans. Data from the National Health and Nutrition Examination Survey III indicate that osteoporosis and low bone density of the hip affects 10 million and almost 34 million people in the United States, respectively. These numbers are only expected to increase with time as the U.S. population continues to age. Osteoporosis is associated with an increased fracture risk and has a significant impact on the individuals it affects, with psychological symptoms, pain, physical limitations and lifestyle changes all part of the complications from this condition.
Description
Alendronate is a type of medication called a bisphosphonate. All bisphosphonates, including alendronate, inhibit the activity of osteoclasts, which are cells that break down the mineralized matrix of bone, a process termed "bone resorption." With continued treatment, osteoclast activity is suppressed, therefore preventing further bone loss.
Effectiveness
The effectiveness of alendronate has been evaluated in multiple studies involving thousands of patients with osteoporosis. Importantly, after several years of continued treatment, alendronate has been shown to increase bone mineral density (a measure of bone loss) and reduce the incidence of new fractures.
Contraindications
There are several conditions under which alendronate should not be used. Specifically, alendronate should be avoided in individuals with esophageal dysfunction of any kind, those who cannot stand or sit for at least 30 minutes, those with hypocalcemia, in individuals with a potential problem with aspiration (i.e., no oral alendronate) and in those with renal insufficiency.
Side Effects
Alendronate is mostly associated with gastrointestinal side effects, including abdominal pain, acid regurgitation, nausea, constipation, diarrhea and flatulence. Some have reported headache and musculoskeletal pain.
Dosing
It is recommended that alendronate be taken first thing in the morning 30 minutes before consuming any food, drink or other medications. If this precaution is not taken into consideration, alendronate may not be properly absorbed by the body, limiting the effectiveness. Alendronate is available in tablet or oral solution form. For osteoporosis in postmenopausal women, the recommended dose is typically 70 mg once weekly or 10 mg once daily. A physician may also recommend additional calcium or vitamin D tablets in those with an insufficient diet. For glucocorticoid-induced osteoporosis, the dose is often 5 mg once daily, except in postmenopausal women in this category, who should take 10 mg per day. For Paget's disease, 40 mg of alendronate should be taken each day for a period of six months.
Tags: alendronate should, postmenopausal women, those with, alendronate been, associated with