Risedronate (Oral Route)

Risedronate is used to treat and prevent bone conditions, such as osteoporosis and Paget’s disease of the bone.

Overview

Although both men and women can suffer from osteoporosis, women are at particular risk of developing the condition. Whilst women tend to have smaller and thinner bones than men anyway, they are more likely to develop osteoporosis after going through the menopause.

Following the menopause, women have significantly less estrogen in their system. This hormone is vital to protecting bone strength and, once it has decreased, bones can become thinner and more fragile. Often used to prevent osteoporosis in women post-menopause, Risedronate may be given as a prophylactic.

In addition to this, Risedronate may be used to treat osteoporosis once the onset has occurred. In both male and female patients, Risedronate can be used to increase bone mass and combat the effects of osteoporosis.

Although patients don’t notice it, new bone is continually being made by osteoblasts and this new growth replaces old bone. In healthy patients, old bone is removed by osteoclasts and this process helps to keep bones strong.

When patients develop osteoporosis, it literally means that the bone has become porous. As the quality and density of the bone decrease, it becomes more fragile and the patient is far more likely to suffer from fractures or broken bones. In some cases, patients can experience fractures from simply carrying out everyday tasks when osteoporosis advances.

By using Risedronate, however, patients can ensure that the decrease in bone density is limited. As a bisphosphonate, Risedronate inhibits the removal of bone by osteoclasts. Due to this, the rate at which bones dissolve or become thinner is reduced and that patient’s overall bone mass should increase. By retaining the bone’s strength, treatment with Risedronate should mean that the patient has less risk of suffering fractures and breaks.

In patients with Paget’s disease of the bone, Risedronate can help to prevent symptoms caused by misshapen and weak bones. When Paget’s disease of the bone occurs, the natural process of bone regrowth is disrupted. As new bone does not successfully replace old bone, the patient’s skeleton can become particularly weak and certain areas may be misshapen. Risedronate can help to prevent the condition from worsening and it can help to increase the patient’s bone strength.

Conditions Treated

  • Osteoporosis
  • Paget’s disease of the bone

Type of Medicine

  • Bisphosphonate

Side effects

Whenever patients take medicine, they are at risk of side effects occurring. Generally, side effects do not complicate treatment as they are relatively mild. In addition to this, patients may only experience side effects for a fairly short period of time as they often diminish as the patient gets used to the treatment.

There are some instances, however, in which side effects warrant medical attention. If patients experience any of the following when taking Risedronate, they should seek medical help:

  • Stomach or abdominal pain
  • Rash on the skin
  • Belching
  • Stomach cramps
  • Bone pain
  • Difficulty swallowing
  • Muscle, joint and/or bone pain, may be severe and/or occasionally incapacitating
  • Pain in chest
  • Heartburn
  • Burning or pain in the throat
  • Vomiting
  • White spots, sores or ulcers inside the mouth, on the tongue or lips

When taking Risedronate, patients may also experience more common side effects. These tend to reduce once treatment has been established and may not require any additional medical intervention:

  • Pain in back
  • Hoarseness or a cough
  • Diarrhea
  • Chills or fever
  • Headache
  • Pain in joints
  • Pain in side or lower back
  • Difficulty urinating
  • Sour or acid stomach
  • Dizziness
  • Bladder pain
  • Cloudy or bloody urine
  • Dry eyes
  • Blurry vision
  • Changes in vision
  • Difficulty moving
  • Congestion
  • Body pain or aches
  • Constipation
  • Painful urination
  • Soreness or dryness of the throat
  • Increased urination
  • General feeling of illness or discomfort
  • Indigestion
  • Cramps in legs
  • Nausea
  • Muscle stiffness or pain
  • Nervousness
  • Swelling, pain and/or redness in the joints
  • Pounding in ears
  • Ringing in ears
  • Fast or slow heartbeat
  • Runny nose
  • Swollen lower legs or feet
  • Stomach upset or discomfort
  • Swollen, tender glands in neck
  • Changes to voice
  • Fainting
  • Weakness
  • Feelings of fear
  • Wheezing
  • Itchy skin
  • Lack of appetite
  • Pale skin
  • Unusual weakness or tiredness
  • Passing gas
  • Blisters on skin
  • Soreness, swelling or redness of the tongue
  • Fullness in the stomach
  • Chest tightness
  • Eye pain
  • Unusual bruising or bleeding
  • Hive-like, large swelling of the eyelids, lips, face, tongue, hands, legs, throat, feet or sex organs
  • Pain in muscles
  • Sore, red eyes
  • Sensitivity of the eyes to light
  • Tearing

When patients experience the side effects listed above, they are normally fairly mild and do present a particular problem. However, if patients are concerned about the presence of any side effects when taking Risedronate, they should always seek medical help.

If patients experience any other adverse effects or if the side effects are particularly severe, they should not hesitate to access medical advice. In addition to this, patients can report the presence of any other adverse effects to the Food and Drug Administration. The FDA compiles details of the side effects associated with numerous medications and ensures that feedback from patients keeps this information up-to-date. If patients choose to report side-effects to the FDA, they can contact the organization on 1-800-FDA-1088.

Dosage

When taking Risedronate, the appropriate dose will depend on the patient’s condition, medical history, age and weight. However, a standard dose for preventing postmenopausal osteoporosis is likely to be 5mg per day or 35mg per week. Usually, this dose should be taken 30 minutes before the patient’s first drink or meal of the day, excluding water. In some cases, patients may be advised to take one 75mg tablet of Risedronate on two consecutive days of the month or one 150mg tablet per month.

If Risedronate is prescribed to male patients with osteoporosis, a standard dose of 35mg once per week is usually given. Again patients are normally advised to take their medication 30 minutes before their first drink or meal.

Similarly, if patients are given Risedronate to treat or prevent osteoporosis caused by the use of corticosteroids, a standard dose is 35mg per week, taken before their first meal or drink of the day.

When prescribed for Paget’s disease of the bone, however, the standard dose of Risedronate is increased significantly. Patients with this condition may be advised to take 30mg of Risedronate per day, 30 minutes before water or food in the morning. Although patients with Paget’s disease of the bone are generally advised to take Risedronate for just two months, doctors may repeat this treatment, depending on the patient’s condition.

When taking standard Risedronate tablets, patients should take their medication on an empty stomach with at least 6-8oz of water. Food and drink will limit the amount of Risedronate which is absorbed by the body so it’s vital that patients take their medication at least 30 minutes before eating or drinking anything other than plain water.

Patients should swallow the tablet whole and should not attempt to chew, dissolve or suck the tablet as this is likely to cause irritation to their throat. Patients should not lie down for at least 30 minutes after taking Risedronate tablets. This will ensure the medication reaches the stomach as quickly as possible and prevents the patient from experiencing irritation of the oesophagus.

Furthermore, patients should ensure that they are consuming a balanced diet and that they are getting enough calcium and vitamin D. Both calcium and Vitamin D are crucial to the healthy bone development and can help to limit the effects of osteoporosis. If patients are advised to take supplements, however, they should be taken some time after Risedronate so that absorption of the medicine is not affected.

In some cases, physicians may prescribe a delayed-release form of Risedronate. If so, patients will normally be told to take 35mg per week, immediately after their breakfast. When taking delayed-release Risedronate tablets, patients should take the tablet with at least 4oz of water and should swallow the tablet whole. The tablet should not be crushed, halved, chewed or diluted prior to taking it.

Patients should confirm whether they are being prescribed standard release or delayed-release tablets before beginning treatment.

Although these are standard doses for adult patients, every individual is different and will require different treatment. Patients should, therefore, follow their doctor’s instructions when taking Risedronate or any other medication. If patients are unsure how to take their medication, they should seek advice from their physician or pharmacist.

If patients are advised to take standard Risedronate tablets on a daily basis and they miss a dose of their medication, they should skip the missed dose and take their next dose of medication as normal.

However, if patients are taking standard Risedronate on a weekly basis and miss a dose, they should take their medication the next morning and then return to their normal schedule next week.

If patients are scheduled to take two standard Risedronate tablets on consecutive days and they miss a dose, they will need to change their schedule. Providing their next dose isn’t due within the next seven days, patients should take their medication the next day, even if it means that tablets aren’t taken consecutively. Patients should not take more than two Risedronate tablets in one week unless they are advised to do so by their physician. If the patient has forgotten to take Risedronate and their next dose is due within 1-7 days, they should skip the missed dose and continue with their treatment schedule as normal.

When patients are advised to take standard Risedronate tablets on a monthly basis, they can take a missed dose the next day, providing their next dose is not due within the next seven days. If their next dose of Risedronate is due within 1-7 days, the patient should skip the dose and take the next dose of medication as they are scheduled to do so. Patients should not take more than one Risedronate tablet within seven days if they are on a monthly dosing schedule.

For patients taking a delayed-release Risedronate tablet on a weekly basis, they should take a missed dose on the next day, if they need to do so. Patients can then return to their normal schedule the following week. Patients should not, however, take two delayed-release Risedronate tablets on the same day and should simply skip the missed dose if they need to.

Warnings

Risedronate has not been associated with a large number of potential drug interactions but it is not usually prescribed alongside Esomeprazole. If physicians decide it is necessary to prescribe these two medications at the same time, they may alter the patient’s dose or treatment schedule so that the chance of an interaction occurring is reduced.

Risedronate can also interact with the dyes used during medical scans. Patients should inform the relevant medical practitioner that they are taking Risedronate if they are due to undergo any scans or medical procedures.

If patients regularly use over-the-counter medicines, supplements and/or vitamins, they should discuss this with their doctor before taking Risedronate. In some instances, prescribed medication can interact with medication which has been purchased by the patient. Similarly, once patients have begun taking Risedronate tablets, they should obtain medical advice before using over-the-counter medicines, supplements and/or vitamins.

If patients have other medical conditions, it may affect whether Risedronate is a suitable medication for them. The following conditions may prevent Risedronate from being prescribed:

  • Bowel and/or stomach problems
  • Anemia
  • Problems with blood clotting
  • Difficulty swallowing
  • Cancer
  • Tooth or dental problems
  • Kidney problems
  • Hypocalcemia
  • Esophagus problems
  • Recent surgery
  • Poor oral hygiene
  • Recent infections

In some instances, Risedronate could worsen existing conditions so will not be prescribed. For some patients, however, the presence of existing health conditions will simply mean that their treatment with Risedronate will be altered or that they will receive additional monitoring whilst they are taking this medication.

Patients who are unable to sit upright or stand for at least 30 minutes should not be prescribed Risedronate. Studies have yet to show whether Risedronate is safe for use in children or infants. Due to this, young patients will not normally be prescribed Risedronate.

Although Risedronate may be prescribed to older patients, they may be given a relatively low starting dose of Risedronate. As older patients may be more likely to have age-related kidney or liver problems, it may take longer for them to process the drug. Due to this, elderly patients may experience more side-effects when taking medications, such as Risedronate. Once their reaction to the medication has been established, doctors may increase the patient’s dose if it is necessary to do so.

Standard Risedronate should not be taken alongside delayed-release Risedronate medications.

Risedronate is not usually considered safe for pregnant patients as the medication may present a risk to the unborn fetus. If there is no alternative medication available and doctors believe the benefits of taking Risedronate outweigh the risks, they may prescribe this medication to patients who are pregnant. However, patients should be made aware of the potential risks and discuss these with their doctor in detail before taking Risedronate. Risedronate can remain in the patient’s system for a long time after the medication has been taken. Due to this, patients should tell their physician if they plan on becoming pregnant in the future before they take Risedronate.

If patients become pregnant when taking standard or delayed-release Risedronate tablets, they should contact their physician for medical advice.

Studies have not shown whether Risedronate can present a risk to infants if patients breastfeed while taking this medication. Due to this, patients are normally advised to stop breastfeeding whilst they are taking Risedronate. As the drug remains in the patient’s system for a significant period of time, patients should not attempt to breastfeed on the days they do not take a Risedronate tablet as the medication could still be passed to the infant. Patients should discuss the risks of breastfeeding whilst taking Risedronate with their doctor before doing so.

When taking Risedronate, patients should have regular consultations and check-ups with their doctor. This will allow their physician to ensure that the medicine is working correctly and that the patient is taking an appropriate dose. In addition to this, doctors can ensure that Risedronate is not having any adverse effects on the patient’s health.

In some cases, Risedronate can irritate the patient’s oesophagus. Symptoms of this may include pain upon swallowing, heartburn, pain in the middle of the chest, difficulty swallowing and/or feeling that food gets stuck in the throat and stomach. If patients suspect that irritation or damage to the oesophagus is occurring, they should stop taking Risedronate and contact their doctor for immediate medical advice.

If patients are due to see any medical professionals or undergo any procedures, they should inform the relevant personnel that they are taking Risedronate. This includes any dental work that the patient may be due to have. Patients may have an increased risk of suffering jaw problems if they have dental procedures carried out whilst taking Risedronate. By informing the dentist that they are taking Risedronate, patients can ensure that they are able to obtain the safest form of treatment.

Patients should inform their doctor if they experience bone, joint or muscle pain whilst taking Risedronate. Similarly, if patients experience any new medical issues, they will need to arrange a consultant with their physician. Patients can be particularly vulnerable to tooth and/or jaw problems when taking Risedronate so it’s important that they seek medical help quickly if they suspect these issues are occurring.

Risedronate can cause calcium levels in the body to decrease. If patients experience muscle twitching or spasms or tingling or numbness in the toes, lips and/or fingers, they may be suffering from a calcium deficiency. Patients should seek medical advice so that this can be confirmed and treated if required.

Although Risedronate can help to prevent patients from suffering from fractures and broken bones, it may increase the risk of fractures occurring in the thigh bone. If patients have aching or pain in the hips, groin or thighs, they should seek medical help.

If patients have taken too much Risedronate, they may experience symptoms of an overdose. These may include:

  • Tremors
  • Shortness of breath
  • Confusion
  • Difficulty breathing
  • Convulsions
  • Irregular heart rate
  • Muscle cramps, particularly in the arms, hands, legs, feet and/or face
  • Tingling or numbness of the fingertips, mouth and/or feet

If patients suspect an overdose has occurred or that they are allergic to Risedronate, they should treat the situation as an emergency and access immediate medical help.

Storage

In order to store Risedronate correctly, patients should follow the instructions issued with their medication. Generally, Risedronate should be kept at room temperature and should be kept away from direct light, moisture and heat. Ideally, Risedronate should be kept in a closed container as this ensures that the medicine remains fresh and that it cannot be contaminated in any way.

When keeping medicines at home, patients will need to ensure that they cannot be accessed by children and/or pets. Placing Risedronate on a high shelf and using a lockable medicine box can help to prevent anyone else from accessing the medication.

If patients are told to stop taking Risedronate or if their medication reaches its use-by date, patients will need to dispose of their tablets. In order to do this, patients should contact their physician or pharmacist so that the medication can be disposed of safely.

Summary

Without effective treatment, osteoporosis can cause significant damage to a patient’s bones and this can result in further complications occurring. When bones are weak or damaged, they can be far less robust than usual and patients may suffer regular fractures.

By increasing bone mass and reducing bone loss, however, Risedronate provides an effective treatment for both osteoporosis and Paget’s disease of the bone.

 

Resources
Last Reviewed:
February 01, 2018
Last Updated:
January 27, 2018