risedronate
Risedronate (Actonel) is a first-choice medication used to treat osteoporosis (bone loss or weakening). It can help improve bone mineral density (BMD) and lower the risk of bone fractures. There are several dosing options and a delayed-release form in case a particular dosing schedule is more convenient for some people.
What is Risedronate (Actonel)?
What is Risedronate (Actonel) used for?
- Osteoporosis in women who have gone through menopause (postmenopause)
- Osteoporosis in men
- Osteoporosis caused by long-term corticosteroid use
- Paget's disease
How Risedronate (Actonel) works
Risedronate (Actonel) is a bisphosphonate. Bisphosphonates work to slow down bone breakdown so the body can make new, healthy, and strong bone. Risedronate (Actonel) helps raise BMD, which is a measure of how dense your bones are. A higher BMD means your bones are stronger, which helps lower your risk of bone fractures.
Drug facts
Side effects of Risedronate (Actonel)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
Note: For once-daily dosing
- Infection (31%)
- Back pain (28%)
- Joint pain (24%)
- Constipation (13%)
- Stomach pain (12%)
- Heartburn (11%)
- Nausea (11%)
- Diarrhea (11%)
- Flu-like symptoms (11%)
- Urinary tract infection (11%)
- Arthritis (10%)
- Headache (10%)
- Bronchitis (10%)
Less Common Side Effects
- Muscle pain
- Neck pain
- Chest pain
- Bone pain
- Bone fractures
- Arm or leg weakness
- Swelling of the arms or legs
- Dizziness
- Runny nose
- Sore throat
- Sinus infection
- Trouble sleeping
- Depression
Risedronate (Actonel) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- New fractures: dull or aching pain in your hips or thigh, severe pain in your bones or joints
The following Risedronate (Actonel) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Less common
Abdominal or stomach pain (severe)
belching
bone pain
cramping of the stomach
trouble swallowing
Rare
Red, sore eyes
Incidence not known
Bone, joint, or muscle pain, severe and occasionally incapacitating
pain or burning in the throat
sores, ulcers, or white spots on the lips or tongue or inside the mouth
vomiting
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
Confusion
convulsions
difficulty with breathing
irregular heartbeats
muscle cramps in the hands, arms, feet, legs, or face
numbness and tingling around the mouth, fingertips, or feet
shortness of breath
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Back pain
cough or hoarseness
fever or chills
headache
joint pain
lower back or side pain
painful or difficult urination
Less common
Acid or sour stomach
bladder pain
bloody or cloudy urine
blurred vision or change in vision
body aches or pains
congestion
difficult, burning, or painful urination
difficulty with moving
dizziness
dryness or soreness of the throat
frequent urge to urinate
general feeling of discomfort or illness
indigestion
leg cramps
muscle pain or stiffness
nervousness
pain, swelling, or redness in the joints
pounding in the ears
ringing in the ears
slow or fast heartbeat
stomach discomfort or upset
swelling of the feet or lower legs
tender swollen glands in the neck
voice changes
weakness
Rare
Fainting
fear
itching skin
loss of appetite
pale skin
passing of gas
redness, swelling, or soreness of the tongue
stomach fullness
tightness in the chest
troubled breathing
troubled breathing with exertion
unusual bleeding or bruising
unusual tiredness or weakness
Incidence not known
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
redness of the eye
sensitivity of the eye to light
skin blisters
tearing
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Risedronate (Actonel)
Pros
- Can be used for many types of osteoporosis
- Many available dosing options (daily, weekly, monthly) for postmenopausal women
- Also comes as a delayed-released form that's taken after breakfast for postmenopausal women
- Available in a lower-cost generic form
Cons
- Risk of many side effects, including stomach pain and severe jaw problems
- Not recommended for people with severe kidney disease
Pharmacist tips for Risedronate (Actonel)
- Don't take risedronate (Actonel) and Atelvia at the same time, since they contain the same active ingredient. Taking two medications that have the same ingredient together can raise your risk of side effects.
- If you're not taking the tablet once a day, mark the dates of your scheduled doses on your calendar to help you remember when to take your medication.
- If you're taking risedronate (Actonel), take the whole tablet first thing in the morning with a full glass of plain water (6 oz to 8 oz) while standing or sitting upright. This lowers your risk of irritating your esophagus. Also, don't eat or drink anything (except plain water) after taking so your body can absorb the medication well.
- If you're taking Atelvia delayed-release tablets, take the whole tablet in the morning right after you eat with at least 4 oz of plain water. Doing so can help lower your risk of stomach pain. Also, don't chew, cut, or crush the tablet. The outer coating of the tablet makes sure that the medication doesn't get released into your body until after it reaches your stomach to help lower stomach problems.
- Take risedronate (Actonel) or Atelvia with plain water and not mineral water. Mineral water can contain more calcium, which can block the medication from working as well.
- Don't chew or suck on the tablet. Also, don't lie down for at least 30 minutes after taking the tablet. Doing so can cause ulcers and irritation in your throat.
- Don't take other medications or supplements (like calcium, antacids, or vitamins) for at least 30 minutes after taking the tablet. Some medications can block risedronate (Actonel) from working as well in the body.
- It's important to have good mouth care when taking this medication to lower the risk of jaw problems. Let your dentist know you're taking risedronate (Actonel) before starting the medication.
- You can take calcium and vitamin D supplements along with the medication to prevent low calcium levels and help your bones grow stronger.
- If you have trouble swallowing, pain when you swallow, chest or stomach pain, new or worsening heartburn, or any pain around your hips, thighs, or jaw, tell your healthcare provider right away.
Common questions about Risedronate (Actonel)
The American Association of Clinical Endocrinology guidelines recommend either risedronate (Actonel) or alendronate (Fosamax) as first-choice options for osteoporosis. Both work well to lower the risk of fractures in different parts of the body, including the hip and back, in postmenopausal women with osteoporosis.
Atelvia is the brand name for the delayed-release form of risedronate (Actonel). Both medications contain the same active ingredient (risedronate), but the delayed-release form might be a more convenient option for some people. You take Atelvia right after breakfast, instead of on an empty stomach like the immediate-release tablets. Taking Atelvia after you eat can help lower the risk of stomach pain or other side effects.
Risedronate (Actonel) can be used to treat or prevent many different types of osteoporosis, while Atelvia is only approved for the treatment of postmenopausal osteoporosis. In addition, risedronate (Actonel) has multiple dosing options (daily, weekly, or monthly) for postmenopausal osteoporosis, whereas there's only one dosing option with Atelvia. The directions for Atelvia is also different from risedronate (Actonel). Please refer to the Pharmacist Tips below for more information on how to take each form of the medication.
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Risks and warnings for Risedronate (Actonel)
Risedronate (Actonel) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Stomach and esophagus irritation and ulcers
- Risk factors: History of ulcers or other digestive problems | Taking with aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) | Not drinking enough water when taking risedronate (Actonel) | Lying down after taking risedronate (Actonel)
Stomach and esophagus irritation, including heartburn, pain, and ulcers, can happen after taking risedronate (Actonel). To help prevent irritation, it's very important to follow the directions on how to take the medication and any other directions your provider has given you. Take risedronate (Actonel) or Atelvia with a full glass of plain water while standing or sitting upright, and avoid lying down for at least 30 minutes. Stop taking risedronate (Actonel) right away and talk to a healthcare provider if you notice you have trouble swallowing, new pain with swallowing, pain around the middle of your chest, or new or worsening heartburn while taking this medication.
Breakdown of the jawbone (osteonecrosis)
- Risk factors: Gum or dental disease or surgery | Anemia (low red blood cell count) | Bleeding problems | Cancer | Taking cancer medications at the same time | Poor mouth care or dentures that don't fit well | Taking risedronate (Actonel) for a long time
Although rare, risedronate (Actonel) can break down and weaken the jawbone. This breakdown is more likely if you get a tooth extraction, dental implants, bone surgery around or in your mouth, or an infection in the mouth that hasn't healed while taking risedronate (Actonel). Keeping your teeth healthy with regular brushing and flossing can lower your risk of this problem. If you notice pain or swelling in your jaw, talk to your doctor or dentist right away. It's also important to let your dentist know that you're taking risedronate (Actonel). You might need to complete any necessary dental work before starting the medication.
Severe bone, joint, or muscle pain
Though rare, some people taking risedronate (Actonel) have had severe pain in their bones, joint, or muscles. It can happen as quickly as one day to several months after starting this medication. Generally, the pain improves after stopping the medication. If you feel severe pain in these areas, talk to a healthcare provider, as you might need to stop risedronate (Actonel).
Leg bone fractures
- Risk factors: Taking corticosteroid medications at the same time
Very rarely, leg bone fractures can happen without any known cause in people taking risedronate (Actonel). If you notice new dull or aching pain in your hips or thighs, tell your healthcare provider right away. You might need to stop taking risedronate (Actonel).
Low calcium in the blood
- Risk factors: History of low calcium in the blood
Risedronate (Actonel) can lower the calcium levels in your blood. If you have low calcium levels, you'll need to be treated before starting risedronate (Actonel) to prevent this problem from getting worse. To help keep your calcium levels from getting too low, you might need to take calcium and vitamin D supplements. Talk to your healthcare provider if you notice muscle spasms or twitching, or numbness and tingling in your fingers, toes, or around your mouth, as these can be signs of low calcium levels.
Risedronate (Actonel) dosage
Typical dosage for Risedronate (Actonel)
- Postmenopausal osteoporosis: There are different dosing options for risedronate (Actonel) depending on how often you would like to take it: 5 mg by mouth once a day, 35 mg once a week, 75 mg on 2 consecutive days each month, or 150 mg once a month.
- Osteoporosis in men: The typical dose is 35 mg by mouth once a week.
- Osteoporosis caused by long-term corticosteroid use: The typical dose is 5 mg by mouth once daily.
- Paget's disease: The typical dose is 30 mg by mouth once daily for 2 months.
Risedronate is also available in a delayed-release form called Atelvia for the treatment of postmenopausal osteoporosis only. The typical dose of Atelvia is 35 mg by mouth once a week.
Interactions between Risedronate (Actonel) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
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Risedronate (Actonel) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Risedronate (Actonel) will not be safe for you to take.
- Issues affecting your esophagus (the tube that connects your throat to your stomach)
- Unable to stand or sit for at least 30 minutes after taking the medication
- Low calcium levels in your blood
What are alternatives to Risedronate (Actonel)?
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