Alendronate gastrointestinal effects

The bisphosphonates deaease bone resorption and slow the progress of osteoporosis. Alendronate is effective for treatment of postmenopausal and steroid-induced osteoporosis. The principal potential side effects are gastrointestinal distress and esophageal ulcers. 

Since both raloxifene and the non-hormonal drug alendronate reduce the incidence of osteoporotic fractures in postmenopausal women it is relevant to determine which approach is better tolerated and thus most likely to promote long-term adherence to therapy. Adverse effects and compliance have been studied in a direct randomized comparison over 12 months in 902 women attending 154 treatment centres in Spain (21). They took either raloxifene 60 mg/day or alendronate 10 mg/day. Those who took raloxifene reported significantly better compliance than those who took alendronate more patients discontinued alendronate prematurely than raloxifene (26% versus 16%. The main reason for premature discontinuation was adverse reactions, particularly gastrointestinal reactions (9.9% with alendronate, 3.4% with raloxifene). 

Alendronate 5 mg/day or 35 mg/week A 50% reduction in the risk of fractures is observed in women with osteoporosis. In younger postmenopausal women without osteoporosis, therapy with alendronate protected all women from bone loss for up to 4 years. Side effects include upper gastrointestinal symptoms, especially if the drug is not taken as directed. 

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