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Legal classification of Medication

POM

Alendronic acid tablets can only be obtained in accordance with a prescription given by an appropriate practitioner and therefore the legal status of the medication is prescription only medication (POM).

Formulations

Alendronic acid is available in tablet form and comes in two strengths of 10mg and 70mg.

Indications

• Treatment of thinning bones (osteoporosis) in postmenopausal women.
• Treatment of thinning of bones in men.
• Prevention and treatment of thinning of bones caused by long term corticosteroid treatment.
• Treatment of bones in which they expand and become deformed (Paget’s disease).

Class of drug

Alendronic acid is a bisphosphonate.

How does it work?

The bones of the skeletal system are continually being reformed by cells called osteoclasts which break down bone cells and osteoblasts which form bone cells. Alendronic acid stops osteoclasts from breaking down calcium from the bones this helps to maintain bone density.

How is it taken?

Alendronic acid is given as a daily tablet or a weekly tablet depending on which condition is treated:

• Thinning of bones in postmenopausal women: 10mg daily or 70mg weekly
• Thinning of bones in men: 10mg daily
• Thinning of bones due to corticosteroid treatment: 10mg daily

Alendronic can cause abnormal reactions to the gullet (oesophagus) such as inflammation, ulcers, and narrowing, for this reason the tablets should be taken whole with plenty of water while sitting or standing, taken on an empty stomach 30 minutes before breakfast or 30 minutes before another oral medicine. Patients should be told to sit upright or stand for at least 30 minutes after taking medicine.

Pregnancy and Breast feeding

Alendronic acid should not be used in the pregnancy or breast feeding as there is no adequate data support its use the two categories.

Contra-indications

Abnormalities of the gullet (oesophagus), such as, difficulty in swallowing and other factors which delay stomach emptying. Alendronic acid reduces calcium levels in the blood and therefore should not be used by patients who constantly have low levels of calcium (hypocalcaemia) in their blood stream.

Side-effects

• Abnormal reactions of the food pipe (oesophageal reactions). Patients should be advised to stop taking alendronic acid and contact their doctor if symptoms such as difficulty in swallowing, pain when swallowing and worsening of heartburn develop.
• Diarrhoea or constipation
• Passing of wind (flatulence)
• Pain in the bones
• Headache

A very rare side-effect of alendronic acid is the reduction of blood supply to the bones of the jaw. All patients are advised to maintain good oral hygiene, receive routine dental check-ups, and report any unusual oral symptoms.