Alendronate and Risedronate for the Treatment of Postmenopausal Osteoporosis: Clinical Profiles of the Once-Weekly and Once-Daily Dosing Formulations

Ronald Emkey, MD


Medscape General Medicine. 2004;6(3):6 

In This Article

Special Dosing Considerations for Bisphosphonates

As with other second- and third-generation oral bisphosphonates, alendronate and risedronate should be taken at least 30 minutes to 1 hour before the first food or drink of the day to avoid interference with absorption. Both medications should be swallowed whole with a full glass of plain water while the patient is in an upright position to minimize the potential for upper gastrointestinal irritation. The patient should not lie down for 30 minutes after taking the medication. Patients should receive supplemental calcium and, if dietary intake is inadequate, supplemental vitamin D. However, the potential for interference with the absorption of alendronate and risedronate necessitates administration of calcium supplements, as well as any calcium-, aluminum-, and magnesium-containing medication, at a different time of the day from the bisphosphonate dose.

The bisphosphonates are not recommended for use in patients with severe renal impairment (defined as creatinine clearance < 30 mL/minute for risedronate and < 35 mL/minute for alendronate); however, no dosage adjustment is necessary in patients with mild-to-moderate renal impairment or in the elderly.