Alendronate chemical structure
Find information on thousands of medical conditions and prescription drugs.

Fosamax

Alendronate (Fosamax®, Merck) is a bisphosphonate drug used for osteoporosis and several other bone diseases. It is marketed alone as well as in combination with vitamin D (2,800 U, under the name Fosavance). more...

Home
Diseases
Medicines
A
B
C
D
E
F
Captagon
Famohexal
Famotidine
Faslodex
Faslodex
Fasoracetam
Felbamate
Felbatol
Felodipine
Felypressin
Femara
Femara
Fempatch
Femring
Fenfluramine
Fenofibrate
Fentanyl
Fexofenadine
Filgrastim
Filipin
Finasteride
Fioricet
Fiorinal
Flagyl
Flarex
Flavoxate
Flecainide
Flexeril
Flomax
Flonase
Flovent
Floxuridine
Fluacizine
Flucloxacillin
Fluconazole
Flucytosine
Fludarabine
Fludrocortisone
Flumazenil
Flunisolide
Flunitrazepam
Fluocinonide
Fluohexal
Fluorometholone
Fluorouracil
Fluoxetine
Fluphenazine
Flurazepam
Flutamide
Fluticasone
Fluvastatin
Fluvoxamine
FML
Focalin
Folic acid
Follutein
Fomepizole
Formoterol
Fortamet
Fortovase
Fosamax
Fosinopril
Fosinoprilat
Fosmidomycin
Fosphenytoin
Frova
Frovatriptan
Frusehexal
Fulvestrant
Fumagillin
Furazolidone
Furosemide
Furoxone
Fusafungine
Fusidic acid
Fuzeon
G
H
I
J
K
L
M
N
O
P
Q
R
S
T
U
V
W
X
Y
Z

Pharmakokinetics

The systemic bioavailability after oral dosing is only 0.6 % as well in women and in men (fasting state). Intake together with meals and certain drinks (coffee, orange juice) further reduces the bioavailability. Soft tissues and bones are fastly reached by about 50%. After resorption in the bone alendronate has an estimated terminal halflife of 10 years; the remainder is excreted unchanged by the kidneys.

Pharmacology

Alendronate blocks osteoblast-mediated bone-resorption. It is chemically related to etidronate and the N-containing bisphosphonates such as pamidronate, which with it shares the same mode of action. Its inhibition of bone-resorption is dose-dependent and 100 to 1,000 times stronger than the equimolar effect of etidronate. Theoretically, alendronate may also inhibit bone-mineralization but this effect is 6,000 times weaker than the inhibition of bone-resorption. Under therapy normal bone tissue develops and alendronate is deposited in the bone-matrix in pharmacologically inactive form. For optimal action enough calcium and vitamin D are needed in the body. Hypocalcemia should therefore be corrected before starting therapy.

Uses

  • Prophylaxis and treatment of female osteoporosis
  • Treatment of male osteoporosis
  • Prevention and treatment of corticosteroid-associated osteoporosis together with supplements of calcium and vitamin D
  • Paget's disease

Contraindications and precautions

  • Acute inflammations of the gastrointestinal tract (esophagitis, gastritis, ulcerations)
  • Clinically manifest osteomalacia
  • Certain malformations and malfunctions of the esophagus (strictures, achalasia)
  • Unability to stand, walk, or sit for 30 minutes after oral administration
  • Renal impairment with a creatinine clearance below 30ml/min
  • Hypersensitivity to alendronate or another ingredient
  • Hypocalcemia
  • Pregnancy and breastfeeding
  • Patients below 18 yrs. of age, because no clinical data exists

Side-effects

  • GI tract: most prominent are harmless side effects such as mild nausea, dyspepsia, abdominal cramps, flatulence, diarrhea, or obstipation. A severe side effect is an ulceration of the esophagus caused by alendronate, which may require hospitalization and intensive treatment. Gastric and duodenal ulceration.
  • General: infrequent cases of skin rash, rarely manifesting as Stevens-Johnson syndrome and toxic epidermal necrolysis, eye problems (uveitis, scleritis) and generalized muscle, joint, and bone pain (rarely severe) have been seen. In laboratory tests decreased calcium and phosphate values may be obtained but reflect action of the drug and are harmless.
  • Osteonecrosis of the jaw, a recognised but rare side-effect of bisphosphonates

Read more at Wikipedia.org


[List your site here Free!]


Long-term results of taking Fosamax
From Healthfacts, 4/1/04

Though Fosamax, the drug that is widely advertised to women, has been on the market for eight years, there are several lingering questions. How long can women safely take this drug? If Fosamax is stopped, will its bone protection benefits disappear? Should it be prescribed to middle-aged women with minimal bone loss?

The most serious concern was raised by some researchers who worry that many years of using Fosamax (or another drug like Actonel in a class called bisphosphonates) could eventually cause more fractures. Bones are constantly being remodeled, breaking down old bone and growing newer healthier bone. Bisphosphonates, however, slows this turnover, which could become counterproductive. By stopping the resorption of the old bone, the drug could prevent its replacement by new bone, thus making the bone more brittle and prone to fracture. With so many unknowns, the more cautious doctors do not prescribe bisphosphonates to women in their 50s. Until there is proof that these drugs are effective at preventing a hip fracture 20 years in the future, this seems like a safe decision because hip fractures are not likely to occur before the age of 70.

Last month, some of the information gaps surrounding Fosamax use were filled in by a pooled analysis of two clinical trials. It was entitled "Ten Years' Experience with Alendronate [Fosamax] in Postmenopausal Women" (New England Journal of Medicine, 3/18/04). Together, the trials involved nearly 1,000 women with osteoporosis, one-third of whom had spinal fractures before entering the studies. They had been randomly assigned to take either Fosamax or a placebo, and the average age at enrollment was 63. The research team led by Henry G. Bone, MD, concluded, "The therapeutic effects of alendronate [Fosamax] were sustained and well tolerated over a 10-year period. The discontinuation of alendronate resulted in the gradual loss of its effects."

But most women take Fosamax to avoid a hip fracture, which has the most serious complications. Unfortunately, the new analysis did not address this issue. Thousands more study participants would have been needed to prove fracture prevention, wrote Dr. Bone in a letter to the New York Times.

COPYRIGHT 2004 Center for Medical Consumers, Inc.
COPYRIGHT 2004 Gale Group

Return to Fosamax
Home Contact Resources Exchange Links ebay