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ALENDRONATE
(brend name: Fosamax)
Pharmacological category: bone resorption
inhibitor |
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Reviews |
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Alendronate |
J Periodontol. 2004 Dec;75(12):1579-85.
Effect of alendronate on periodontal disease in postmenopausal
women: a randomized placebo-controlled trial.
Rocha ML, Malacara JM, Sanchez-Marin FJ, Vazquez de la
Torre CJ, Fajardo ME.
Institute of Medical Research, University of Guanajuato, Leon, Mexico.
BACKGROUND: We investigated the effect of oral alendronate (ALN) treatment
on radiological and clinical measurements of periodontal disease in postmenopausal
women without hormone replacement therapy. METHODS: We evaluated the effect
of 6 months of ALN treatment in 40 postmenopausal women, 55 to 65 years
old with established periodontal disease, in a controlled, double-masked,
prospective study. Volunteers were paired by age and randomized to receive
ALN (10 mg/day) or placebo for the study period. Periodontal mechanical
treatment was carried out in both groups. At baseline and after treatment,
clinical evaluation, hormone blood levels, distance from the crestal alveolar
bone (CAB) to the cemento-enamel junction (CEJ), calcaneus bone mineral
density (BMD), hormone levels, serum N-telopeptide (NTx), and bone-specific
alkaline phosphatase (BSAP) were assessed. RESULTS: Periodontal disease
conditions improved in both groups, but greater improvement in probing depth
(-0.8 +/- 0.3 mm versus -0.4 +/- 0.4 mm, P = 0.02) and gingival bleeding
(-0.3% +/- 0.13% versus -0.2% +/- 0.06%, P = 0.006) was found in the ALN
treated group. Calcaneus BMD increased in the ALN treated group (68 +/-
47 mm3 versus -26 +/- 81 mm3, P = 0.0006). CAB-CEJ distance diminished in
the ALN group (-0.4 +/- 0.40 mm versus 0.60 +/- 0.53 mm, P = 0.00008). Marginal
reduction in both NTx and BSAP levels was found in the ALN group (-9.4 +/-
6.6 nmol versus -4.3 +/- 4.7 nmol bone collagen equivalents, P = 0.08, and
-7.7 +/- 8.4 versus -1.5 +/- 5.0 U/l, P = 0.1, respectively). Hormone levels
were unchanged after treatment. Similar improvement of calcaneus BMD and
CAB-CEJ distance with ALN treatment was found in obese and non-obese women.
CONCLUSION: ALN treatment improved periodontal disease and bone turnover
in postmenopausal women. |
Effect of alendronate
on bone mineral density and bone turnover in Thai postmenopausal osteoporosis.
J Bone Miner Metab. 2003;21(6):421-7.
Chailurkit LO,
Jongjaroenprasert W, Rungbunnapun S, Ongphiphadhanakul B, Sae-tung S, Rajatanavin
R.
Department of Medicine, Ramathibodi Hospital, Mahidol University, Rama
6th Road, Bangkok, Thailand.
Alendronate has recently been approved for the prevention and treatment
of postmenopausal osteoporosis, and its efficacy has been demonstrated in
many Western countries. Our present study was performed to evaluate the
effect of alendronate on bone mineral density (BMD) and its tolerability
in Thais. Eighty postmenopausal women with osteoporosis participated in
this study. After giving informed consent, the subjects were randomly allocated
either 10 mg alendronate or placebo in a double-blind fashion. All patients
received a supplement of 500 mg elemental calcium daily. BMD at the lumbar
spine, femoral neck, and distal forearm was measured at baseline and 6 and
12 months after treatment. Biochemical markers of bone resorption were determined
at baseline and 6 months after treatment. Baseline characteristics were
similar in both alendronate- and placebo-treated groups. Ten subjects discontinued
the study. Of 70 subjects, 32 received 10 mg alendronate daily and the remaining
subjects received placebo. At 1 year, BMD in the alendronate-treated group
had increased from baseline by 9.2%, 4.6%, and 3.1% at lumbar spine, femoral
neck, and distal forearm, respectively. These percentages were greater than
those in controls (4.1%, 0.6%, and 1.0%, respectively). Urinary N-terminal
telopeptide (NTx)-I and serum C-terminal telopeptide (CTx)-I levels decreased
in both groups after 6 months of treatment. However, more reduction was
demonstrated in the alendronate-treated group (71.9% vs. 28.4%, P < 0.01,
and 84.7% vs. 33.1%, P < 0.01, respectively). Compliance with treatment
and drug tolerability were good in both alendronate and placebo groups.
We concluded that treatment with alendronate 10 mg daily for Thai postmenopausal
women with osteoporosis significantly increased BMD at all skeletal sites
and reduced biochemical markers of bone resorption. It was well tolerated
without any serious side effects. |
Postgrad Med. 2003 Sep;114(3):22-8,
32
Hip fracture prevention. Drug therapies and lifestyle
modifications that can reduce risk
Fiechtner
JJ
Colleges of Human and Osteopathic Medicine, Michigan State University, East
Lansing, USA
The annual number of hip fractures sustained worldwide is expected to increase
dramatically as the population ages. Adequate calcium and vitamin D intake
and exercise are fundamental to any program for bone loss prevention or
osteoporosis treatment. Fall prevention programs, weight-bearing and resistance
exercise, hip protector use, and calcium and vitamin D supplementation can
reduce hip fracture risk. Among the available antiosteoporosis agents, the
bisphosphonates risedronate and alendronate have produced the greatest reductions
in hip fracture risk in postmenopausal women. Nasal calcitonin and raloxifene
have not demonstrated significant reductions in nonvertebral or hip fracture
risk. The role of parathyroid hormone (1-34) in the treatment of hip fractures
remains uncertain until more experience is gained about its use and studies
with sufficient statistical power are performed. Data indicate that bisphosphonates
consistently reduce hip fracture risk in patients with osteoporosis, especially
those with an existing vertebral fracture. In addition to pharmacologic
intervention, adequate nonpharmacologic preventive strategies should be
included to ensure maximal reduction in risk of hip fracture. |
| J Womens Health Gend
Based Med 2002 Apr;11(3):211-24
Combination treatment of osteoporosis: a clinical
review
Crandall C
Department of Medicine, UCLA School of Medicine, UCLA National Center
of Excellence in Women's Health (U.S. Dept. of Health & Human Services),
Iris Cantor-UCLA Women's Health Center, 90095-7023, USA
OBJECTIVE: Because of the limited efficacy of available agents and to
limit toxicity, there is considerable interest in combination pharmacotherapy
for osteoporosis. METHODS: A search was performed for randomized controlled
trials in MEDLINE (1966-present) using the keywords osteoporosis treatment
and combination. RESULTS: Twenty-four randomized controlled trials evaluated
osteoporosis medications in combination. Study duration ranged from 1
to 4 years. No serious adverse events were definitively attributable to
study drugs. Fracture reduction outcome is not shown for any combination
regimen. The literature was mixed regarding bone density augmentation.
Combinations of nandrolone decanoate plus calcitonin, calcitonin plus
growth hormone (GH), or pamidronate plus GH may be contradictory or detrimental
to bone mineral density (BMD). For postmenopausal osteoporosis or osteopenia,
four combinations appear to increase hip and lumbar BMD: 10 mg alendronate
with 0.625 mg conjugated equine estrogens (CEE), cyclic etidronate with
0.625mg CEE, 10 mg alendronate with 2 mg estradiol (E(2)), and tibolone
with fluoride. For steroid-related osteoporosis, intermittent etidronate
with fluoride increases lumbar BMD. CONCLUSIONS: The few trials including
Food and Drug Administration (FDA)-approved medications suggest that 10
mg/day alendronate with estrogen (equivalent of 0.625 mg CEE daily) can
increase BMD moreso than each medication given singly in postmenopausal
osteoporotic women. Estrogen dose and type must be controlled in future
trials. Long-term safety data are lacking. The utility of these combinations
rests on whether bone density changes will translate into decreased fracture
rates. |
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Drug information |
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| GENERIC NAME: alendronate
BRAND NAME: Fosamax
DRUG CLASS AND MECHANISM: Alendronate is in a class of
medications used to strengthen bone. Bone is in a constant state of remodeling,
whereby old bone is removed by cells called osteoclasts, and new bone
is laid down by cells called osteoblasts. Alendronate inhibits bone removal
by the osteoclasts.
PREPARATIONS: tablet: 10mg (daily); 70mg (weekly)
STORAGE: Store at room temperature, sealed container,
avoid moisture.
PRESCRIBED FOR: Alendronate is used to treat osteoporosis
(thinning of bone) in women after menopause. After menopause, there is
an increased rate of bone loss (resorption). In these patients, alendronate
has been shown to increase bone density while strengthening bone, and
decrease the rate of bone fractures. Alendronate is also helpful in the
treatment of Paget's disease of the bone. Paget's disease is characterized
by a disorderly and accelerated remodeling of the bone, leading to bone
weakness and pain.
DOSING: Since food, other medications, and vitamins
can interfere with the absorption of alendronate, it should be taken at
least 30 minutes before food, beverage, vitamins or medicines. In order
to avoid chemical irritation of the esophagus (the tube that connects
the mouth with the stomach), alendronate should be taken with a full glass
of plain water first thing in the morning and never chewed or sucked.
It should be avoided by patients with abnormalities of the esophagus which
delay esophageal emptying, such as scarring (stricture) or poor motility
(achalasia). Patients should also not lie down for 30 minutes after swallowing
the tablets. Those patients who are unable to remain upright for at least
30 minutes after taking medication should avoid alendronate.
DRUG INTERACTIONS: The safety of alendronate in patients
with significant kidney disease is not known. Therefore, it is not recommended
for patients with significant kidney conditions. Since alendronate can
lower blood calcium, low blood calcium levels are corrected prior to use.
Calcium supplements, antacids and medications can interfere with the absorption
of alendronate.
PREGNANCY: The safety and effectiveness of alendronate
has not been established in children or women who are pregnant or nursing.
NURSING MOTHERS: The safety and effectiveness of alendronate
has not been established in children or women who are pregnant or nursing.
SIDE EFFECTS: Alendronate is generally well tolerated.
Side effects are infrequent and mild. Side effects include stomach pain
or upset, constipation, diarrhea, muscle ache, and headache. Alendronate
can irritate the esophagus to cause heartburn in patients who lie down
flat after swallowing, thereby delaying passage of the medication to the
stomach.
Caution! Before starting
to take this medicine, it is vital that you should consult your doctor!
Do not use it on your own initiative, without medical advice.
Also, you should read carefully important health information about this
drug given here:
www.nlm.nih.gov |
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Order now ! |
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Dosage |
Packing |
Price |
Pay now |
10 mg |
30 tab |
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10 mg |
60 tab |
USD 53.00 |
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10 mg |
90 tab |
USD 0.00 |
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10 mg |
180 tab |
USD 83.00 |
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70 mg |
8 tab |
USD 49.00 |
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70 mg |
16 tab |
USD 79.00 |
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70 mg |
32 tab |
USD 139.00 |
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