Alendronate 4 NSAIDs

Uses Rx prevent osteoporosis male female, Rx steroid-induced osteoporosis, Paget Dz Action -1- N1 abnormal bone resorption Dose Osteoporosis Rx 10 mg/d PO or 70 mg qwk Fosamax plus D 1 tab qwk Steroid-induced osteoporosis Rx 5 mg/d PO Prevention 5 mg/d PO or 35 mg qwk Paget Dz 40 mg/d PO Caution [C, ] Not OK if CrCl <35 mLAnin, w/ NSAID use Contra Esophageal anomalies, inability to sit/stand upright for 30 min, X Ca Disp Tabs, soln SE GI disturbances, esophageal irritation, HA, pain, jaw osteonecrosis (w/ dental procedures, chemo) Interactions -1- Absorption W7 antacids, Ca supls, Fe, food T risk of upper GI bleed W/ ASA NSAIDs EMS May cause cardiac conduction abnormalities d/t T Ca T risk of jaw fractures esp w/ dental procedures OD May cause hypocalcemia and adverse upper-GI effects milk or antacids can be given to bind alendronate... 

ALENDRONATE ANALGESICS-NSAIDs Risk of oesophagitis/peptic ulceration Additive effect Avoid co-administration... 

The status of this interaction is currently controversial. Some consider that alendronate should not be given to patients receiving NSAIDs, while others urge caution in their use together. However, some consider that there is no evidence that alendronate adds to the known gastrointestinal toxicity of NSAIDs, and the manufacturer issues no caution about the concurrent use of NSAIDs. Until further evidence is available, it would seem sensible to monitor the concurrent use of alendronate and NSAIDs carefully. 

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