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Risedronate: Uses, Dosage, Side Effects & Bone Health Benefits
Summary or Key Points
Risedronate is a medication commonly used to treat and prevent bone disorders such as osteoporosis and Paget’s disease. It works by slowing bone loss, helping to maintain bone strength and reduce the risk of fractures. Risedronate is typically taken orally and requires specific usage instructions to ensure its effectiveness. Always consult your healthcare provider before starting or adjusting your dose. Our telemedicine providers are available to assist with any questions you may have.
Names of Medication
US Brand Name: Actonel (Risedronate)
US Brand Name: Atelvia (Risedronate)
The generic name refers to the active ingredient, listed in parentheses, while the brand name is the name given by the manufacturer.
Pharmacologic Category
Bisphosphonates
Risedronate Dosage
Risedronate is prescribed for a variety of bone-related conditions, with the dosage depending on the specific condition being treated. Always follow your healthcare provider’s instructions and consult them before making any changes to your dose. Our telemedicine providers are available to address any questions or concerns about your treatment.
Osteoporosis (Postmenopausal and Men)
Prevention: 5 mg orally once daily, or 35 mg once weekly, or 150 mg once a month.
Treatment: 5 mg orally once daily, or 35 mg once weekly, or 150 mg once a month.
Paget’s Disease of Bone
Treatment: 30 mg orally once daily for 2 months. Retreatment may be considered after a 2-month break if symptoms persist.
Glucocorticoid-Induced Osteoporosis
Prevention and Treatment: 5 mg orally once daily.
Osteopenia
Treatment: 5 mg orally once daily, or 35 mg once weekly, or 150 mg once a month.
Bone Metastases
Treatment: Consult your healthcare provider for specific dosing recommendations.
Hypercalcemia of Malignancy
Treatment: Consult your healthcare provider for specific dosing recommendations.
Osteogenesis Imperfecta
Treatment: Consult your healthcare provider for specific dosing recommendations.
Osteomalacia
Treatment: Consult your healthcare provider for specific dosing recommendations.
Renal Osteodystrophy
Treatment: Consult your healthcare provider for specific dosing recommendations.
Fibrous Dysplasia
Treatment: Consult your healthcare provider for specific dosing recommendations.
Dosage Forms and Strengths
Tablets: 5 mg, 30 mg, 35 mg, 150 mg
Delayed-release tablets: 35 mg
Administration Instructions for Risedronate
Take Risedronate first thing in the morning, at least 30 minutes before consuming any food or beverages other than water. Swallow the tablet whole with a full glass of water (6-8 ounces). To prevent esophageal irritation, do not lie down for at least 30 minutes after taking the medication. If you miss a dose, follow your healthcare provider’s instructions. If you have any questions about your medication schedule, our telemedicine providers are here to help.
Risedronate Side Effects and Adverse Reactions
As with all medications, Risedronate may cause side effects. Some are more common, while others are rare but potentially serious. Always inform your healthcare provider if you experience any unusual symptoms.
Common Side Effects of Risedronate
Stomach pain: This may occur due to irritation of the stomach lining.
Heartburn: A burning sensation in the chest, often caused by acid reflux.
Diarrhea: Loose or watery stools.
Headache: Mild to moderate head pain.
Serious Side Effects (Rare)
Esophageal ulcers: Sores in the esophagus that can cause pain and difficulty swallowing.
Jawbone problems (osteonecrosis): A rare but serious condition where the jawbone weakens and deteriorates.
Unusual thigh bone fractures: Rare fractures that may occur with long-term use of the medication.
Severe allergic reactions: Symptoms may include rash, itching, swelling, or difficulty breathing.
Contraindications for Risedronate
A contraindication is a specific condition where a medication should not be used due to potential harm. If you have any of the following conditions, avoid taking Risedronate and discuss alternative treatments with your healthcare provider.
Esophageal abnormalities: Conditions such as esophageal stricture (narrowing) or achalasia (difficulty swallowing) can be worsened by Risedronate, as it may irritate the esophagus.
Inability to sit or stand upright for at least 30 minutes: Lying down too soon after taking Risedronate can lead to esophageal irritation. Remaining upright helps prevent this.
Hypocalcemia (low calcium levels): Risedronate can further lower calcium levels, which can be dangerous if you already have hypocalcemia. Ensure calcium levels are corrected before starting this medication.
Severe kidney disease: Risedronate is primarily eliminated through the kidneys. If your kidney function is impaired, the medication may not be cleared properly, increasing the risk of side effects.
Allergic reactions: If you have had an allergic reaction to Risedronate or any of its ingredients, you should not take this medication.
Drug to Drug Interactions with Risedronate
Risedronate can interact with other medications, potentially affecting its effectiveness or increasing the risk of side effects. Be sure to inform your healthcare provider about all medications you are taking, including over-the-counter drugs, supplements, and vitamins.
Calcium supplements or antacids: These can interfere with Risedronate absorption. Take them at least 30 minutes after Risedronate.
Nonsteroidal anti-inflammatory drugs (NSAIDs): Medications such as ibuprofen (Advil, Motrin) or naproxen (Aleve) can increase the risk of gastrointestinal irritation when taken with Risedronate.
Aspirin: Taking aspirin with Risedronate may heighten the risk of stomach or esophageal irritation.
Proton pump inhibitors (PPIs): Medications like omeprazole (Prilosec) or esomeprazole (Nexium) may reduce Risedronate’s effectiveness by altering stomach acid levels, which are important for its absorption.
Risedronate in Pregnancy
Is it safe to take Risedronate when pregnant?
Risedronate is generally not recommended during pregnancy due to limited data on its safety in pregnant women. Animal studies have indicated potential risks to the fetus. If you are pregnant or planning to become pregnant, it’s important to consult your healthcare provider to discuss alternative treatments. You can also schedule a telemedicine visit with one of our providers to explore safer options for managing bone health during pregnancy.
Risedronate While Breastfeeding
Is it safe to take Risedronate while breastfeeding?
There is limited information on whether Risedronate passes into breast milk. Due to the potential risks to a nursing infant, it is generally advised to avoid using Risedronate while breastfeeding. If you are breastfeeding and require treatment for bone health, consult one of our telemedicine providers to discuss safer alternatives to Risedronate sodium.
Estimated Cost of Risedronate
The estimated cost of a 30-day supply of Risedronate without insurance, using a GoodRx coupon, ranges from $15 to $30. Prices may vary depending on the pharmacy and location. Be sure to check for discounts or coupons that may help lower the cost of Risedronate sodium.
Possible Alternatives to Risedronate
If Risedronate is not suitable for you, there are alternative treatments and lifestyle changes that may help manage your condition. Always discuss these options with your healthcare provider before making any changes to your treatment plan. You can also consult one of our telemedicine providers to explore these alternatives to Risedronate.
Osteoporosis Treatment Alternatives
Alternatives to Risedronate for osteoporosis include other bisphosphonates such as alendronate (Fosamax) or ibandronate (Boniva), as well as denosumab (Prolia) or hormone replacement therapy. In addition, weight-bearing exercises, calcium and vitamin D supplements, and quitting smoking can all contribute to improving bone health.
Paget’s Disease of Bone
For Paget’s disease of bone, alternative treatments include alendronate and zoledronic acid (Reclast). Physical therapy and pain management strategies may also help alleviate symptoms.
Glucocorticoid-Induced Osteoporosis
For glucocorticoid-induced osteoporosis, denosumab or teriparatide (Forteo) may be considered as alternatives to Risedronate. Reducing glucocorticoid use, if possible, and ensuring adequate calcium and vitamin D intake are also important for maintaining bone health.
Osteopenia
For osteopenia, lifestyle changes such as regular exercise, a balanced diet rich in calcium and vitamin D, and avoiding smoking and excessive alcohol consumption can help slow bone loss. Medications like alendronate or raloxifene (Evista) may also be considered as alternatives to Risedronate.
Bone Metastases
For bone metastases, denosumab (Xgeva) or zoledronic acid (Zometa) are commonly used alternatives. Radiation therapy and pain management strategies may also be part of the overall treatment plan.
Hypercalcemia of Malignancy
For hypercalcemia of malignancy, zoledronic acid or denosumab are often used to manage elevated calcium levels caused by cancer. Hydration and medications to lower calcium levels may also be necessary.
Osteogenesis Imperfecta
For osteogenesis imperfecta, bisphosphonates like pamidronate or zoledronic acid may be used. Physical therapy, bracing, and surgical interventions may also be part of the comprehensive treatment plan.
Osteomalacia
Treatment for osteomalacia typically involves correcting vitamin D deficiency and ensuring adequate calcium intake. In some cases, phosphate supplements may be required to manage the condition.
Renal Osteodystrophy
For renal osteodystrophy, managing kidney disease and maintaining proper calcium and phosphate balance are key. Medications such as calcitriol or phosphate binders may be used to support bone health.
Fibrous Dysplasia
For fibrous dysplasia, bisphosphonates like alendronate or pamidronate may help manage bone pain. In severe cases, surgery may be necessary to correct bone deformities.
Recent Updates on Risedronate Research
Recent studies have focused on the long-term safety and effectiveness of Risedronate in treating osteoporosis and other bone-related conditions. Research indicates that Risedronate continues to reduce fracture risk in osteoporosis patients, even after several years of use. However, ongoing investigations are exploring the optimal duration of treatment, as long-term use of bisphosphonates like Risedronate may be associated with rare side effects, such as atypical femur fractures and osteonecrosis of the jaw.
Additionally, new research is examining the use of Risedronate in combination with other therapies, such as denosumab, to further enhance bone density and reduce fracture risk in high-risk patients. If you have concerns about long-term Risedronate use or are interested in exploring new treatment options, consider scheduling a telemedicine consultation with one of our providers to discuss the latest research and how it may apply to your treatment plan.
