Actonel drug use, side effects, for osteoporosis and bone thinning
September 24 2017 by Ray Sahelian, M.D.

Actonel is a prescription medication used for the treatment of postmenopausal osteoporosis.

Actonel side effects, danger
Side effects for risedronate sodium tablets may include back, muscle, bone or joint pain, stomach pain or upset, or constipation. Sometimes a doctor who prescribes it does not tell their patient all the potential bad side effects. A very serious long term Actonel side effect is osteonecrosis of the jaw.

Actonel and osteonecrosis
With the millions of patients receiving various oral bisphosphonates for osteopenia and osteoporosis, many more cases of osteonecrosis are likely to emerge.

Osteonecrosis of the jaws associated with use of risedronate Actonel : Report of 2 new cases.
Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology. 2007.
More than a thousand cases of osteonecrosis of the jaw attributed to bisphosphonates have been reported in the English-language literature. Approximately 96% of these published cases were seen with administration of the intravenous agents pamidronate and zoledronate, whereas only 26 cases have been associated with oral bisphosphonates. Only a single case of osteonecrosis of the jaws associated with the oral bisphosphonate risedronate has been previously cited. We report 2 cases of osteonecrosis of the jaws attributed to risedronate Actonel administration. The patients developed osteonecrosis 15 and 24 months after treatment for osteopenia. A regimen of antibiotics and chlorhexidine mouthrinse resolved the osseous defect in the mandible caused by complete exfoliation of a lingual torus in 1 patient. The other patient required sequestrectomy, repeated courses of antibiotics, surgical debridement, and steroids to promote closure of an oroantral fistula and management of sinusitis after bone grafting and implant placement in the posterior maxilla.

New Zealand Medical Journal 2014. Bisphosphonate-associated atypical subtrochanteric femur fractures in the older patient. Bisphosphonates, drug of choice in the treatment of osteoporosis, have been associated with unusual skeletal side effects such as osteonecrosis of jaw and atypical femur fractures in recent years. We report two older patients with bisphosphonate-associated atypical femur fracture from a South Australian tertiary care hospital and a brief discussion of potential diagnostic complexities in this patient population.

Actonel medication dosage - Actonel 35 mg and 5 mg
Actonel tablet 35 mg once-a-week and 5 mg tablet daily are indicated for the treatment and prevention of osteoporosis in postmenopausal women. Actonel tablet 5 mg daily is also indicated for the treatment and prevention of glucocorticoid-induced osteoporosis in men and women who are either initiating or continuing systemic glucocorticoid treatment (10 mg/d of prednisone or equivalent) for chronic diseases.

Q. Which is better to take 35mg once weekly or Actonel 5 mg daily?
   A. Not enough long term studies have been done to determine whether weekly Actonel 35mg is a better option than daily Actonel 5 mg. Many people gradually reduce their use of daily Actonel medication use which may be a good thing since this could reduce side effects. Up to 40 percent of Actonel 35mg users eventually stop taking their medication.

Medication persistence with weekly versus daily doses of orally administered bisphosphonates.
Endocr Pract. 2006.
To compare medication persistence among patients receiving daily orally administered bisphosphonates with persistence among patients receiving weekly orally administered bisphosphonates to ascertain whether less frequent dosing is associated with better long-term treatment persistence. This study demonstrates that weekly dosing of orally administered bisphosphonates is associated with higher medication persistence than is daily dosing. Nevertheless, more than 40% of patients did not persist with weekly bisphosphonate therapy for at least 12 months. Thus, medication persistence was inadequate even with use of the weekly regimen. Additional research is needed to determine whether persistence can be further improved by extending the dosing interval beyond once weekly.

Actonel prescribing information
Actonel 5 mg (Daily), Actonel 35 mg (Once-a-Week), Actonel 75 mg (Two consecutive days each month) and Actonel 150 mg (once-a-month) are indicated for the prevention and treatment of osteoporosis in postmenopausal women. Risedronate is generic for Actonel.

I am 55 years old. I fractured both heels to find that I have osteoporosis. Two years running (second test just received today) shows the same T-score of -2.70, Z-score of 1.80. I have been taking a D supplement; last year measured 25-Hydroxy of 45, this year of 32. My Primary wishes to start the monthly 150mg Actonel. The product flier only shows the 35mg treatment indicated for males. What is the right dosage?
   I focus on natural
supplements as a treatment for osteoporosis and I do not think this drug is safe enough.

Fosamax Actonel pill
Which medication is better? The drugs, Fosamax (generic name, alendronate) and Actonel (generic name, risedronate sodium), belong to a group of drugs called bisphosphonates. Fosamax and Actonel are commonly used to prevent and treat osteoporosis in post-menopausal women. Fosamax and Actonel are not estrogens and do not carry the associated risks or benefits of estrogen (see the hormone replacement therapy section above), but they carry their own set of risks. Long term studees are not available comparing Fosamax to Actonel and hence it is too soon to tell which medication is better or worse. In the short term, it appears Actonel works faster.

Actonel osteoporosis
Actonel and Fosamax both help with osteoporosis after menopause. Actonel (made by Procter & Gamble) and Fosamax (made by Merck) are both effective treatments for age-related osteoporosis. This kind of bone loss is a particular problem for women after menopause.

Alternative, natural dietary supplements as alternative
Since Actonel can have serious medication side effects, it is a good idea for doctors to think about an alternative to avoid potential long term health problems. Actonel medication should only be prescribed if absolutely necessary. Increased calcium intake, vitamin D, sun exposure and weight training are excellent alternatives to Actonel.

Actonel and calcium product
Actonel with calcium plus is a prescription medication to treat and prevent postmenopausal osteoporosis.

Interactions
Q. Is it okay to take a multivitamin product along with Actonel with calcium?
   A. Yes, as long as the multi vitamin product does not have too high an amount of calcium.