Take risedronate sodium tablets first thing after you get up in the morning. Swallow the tablet whole with a large glass of plain water, at least half an hour before you have breakfast. Remain sitting or standing upright for at least 30 minutes after taking the tablet.
Each time you collect a prescription, make sure you have been given the same strength of tablet as you have had before. This is because there are three different strengths of risedronate sodium tablets and not all will be suitable for you.
If you buy any medicines 'over the counter', make sure your pharmacist knows that you are taking a bisphosphonate medicine, as some medicines will prevent risedronate sodium from working properly.Good dental hygiene is particularly important with this treatment - this means that you must brush your teeth regularly, and have routine dental check-ups.
About risedronate sodium
|Type of medicine||A bisphosphonate|
|Used for||Osteoporosis; Paget's disease of bone|
|Also called||Actonel®; Actonel Once A Week®; Actonel® Combi (a combination preparation containing risedronate tablets and sachets of calcium carbonate and colecalciferol)|
Risedronate sodium, a bisphosphonate medicine, is prescribed for the treatment of two conditions which affect the bones. It is prescribed as a treatment for 'thinning' of the bones (osteoporosis), and it is also used to prevent bone damage in people with Paget's disease of bone.
Osteoporosis is a bone disease which causes bones to become brittle and fragile, making them prone to breaks and fractures. During our lifetime, old bone tissue is constantly being broken down and replaced by new bone. As we get older, our bone begins to lose density because old bone is lost faster than new bone can replace it. Women in particular have an increased risk of developing osteoporosis because they lose bone material rapidly after the menopause. Risedronate sodium slows down the rate at which old bone is lost. New bone continues to be made and this leads to an overall increase in bone density, which reduces the risk of broken bones and fractures. Bones also need calcium and colecalciferol (vitamin D3) to help keep them strong and healthy.
In Paget's disease of bone, risedronate sodium works on bones to make them stronger and help prevent bone thickening. This helps ease symptoms such as pain, bone damage and fracture.
Before taking risedronate sodium
Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking risedronate sodium tablets it is important that your doctor knows:
- If you are pregnant or breast-feeding. Risedronate sodium is not suitable for women who could become pregnant.
- If you have ever had any difficulties swallowing.
- If you are due to have any dental treatment in the near future, or if you have not recently had a dental check-up.
- If you have any problems with the way your kidneys work.
- If you are unable to sit upright for at least 30 minutes.
- If you have been told you have low amounts of calcium in your blood.
- If you are taking any other medicines. This includes any medicines which are available to buy without a prescription, as well as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How to take risedronate sodium
- Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about risedronate sodium, and it will also provide you with a full list of the side-effects which you could experience from taking it.
- Take the tablets exactly as your doctor tells you to. There are three strengths of risedronate sodium tablets available - 5 mg, 30 mg and 35 mg. The 30 mg tablets are prescribed for people with Paget's disease, whereas people being treated for 'thinning' of the bones (osteoporosis) will receive either the 5 mg or 35 mg strength tablet. Depending upon which strength of tablet you are prescribed, your doctor will ask you to take either one dose each day or one dose each week. As a guide, if you are given 5 mg or 30 mg tablets, these are taken each day. If you are given 35 mg tablets, these are taken on one day of the week only. If you are unsure about how often to take your tablets, ask your pharmacist or doctor for further advice.
- Take your tablet first thing after getting up in the morning. Swallow your tablet whole (do not crush or chew the tablet). Take it with a large glass of plain water, at least 30 minutes before you have any food, or other drinks or medicines. It is important that you remain sitting or standing upright for at least 30 minutes afterwards - this is to stop the tablet from getting stuck in your throat or doing any damage before it reaches your stomach.
- If you forget to take your tablet first thing in the morning, you can take it when you remember later in the day, provided that you do not eat food or have anything to drink during the two hours before you take the tablet, or during the two hours afterwards. It is particularly important you do not have any milk, or any drinks containing milk during this time. If this is not possible, or if it is getting near to bedtime, then do not take a tablet on that day. If you normally take risedronate each day, just carry on as usual the next day - do not take a double dose to make up for the missed tablet. If you usually take risedronate just once a week, then take the missed dose on the following day, and then take your next dose on your usual day of the week.
- If you are taking Actonel® Combi, this is a combination treatment which contains risedronate sodium tablets (Actonel®) and sachets which contain granules of calcium and colecalciferol. It is a treatment for women. You will be asked to take one Actonel® tablet on the first day of every week and one sachet of granules for the other six days of the week. Follow the instructions above for taking the tablets. To take the granules, dissolve the contents of one sachet into a glass of water, stir it to mix, and then drink it as soon as the fizzing has stopped. Foods which contain spinach, rhubarb and whole cereals can prevent you from absorbing the full amount of calcium - it is best to avoid these types of food for the two hours before and the two hours after taking the granules. Never take risedronate tablets on the same day as you take the sachets.
Getting the most from your treatment
- Do not take any mineral supplements or any indigestion remedies, or anything which might contain iron or calcium during the two hours before and the two hours after taking risedronate sodium. This is because these things interfere with risedronate sodium and stop it from being absorbed by your body. Also, you should never take risedronate sodium tablets before you get out of bed in the morning, or at bedtime.
- Remember to keep your regular appointments with your doctor so that your progress can be monitored.
- Good dental hygiene is important during treatment with this medicine - this means that you must brush your teeth regularly and have regular dental check-ups. You should also make sure that your dentist is aware that you are taking risedronate sodium, as some dental treatments may not be recommended for you while you are taking the tablets.
- Treatment with risedronate sodium will last several months or longer. Continue to take the tablets until you are advised otherwise by your doctor.
- It may be necessary for you to take supplements of calcium and vitamin D alongside this treatment. If so, your doctor will prescribe these for you.
- If you buy any medicines, check with a pharmacist that they are suitable for you to take. This is because mineral supplements, iron preparations, and some indigestion remedies reduce the amount of risedronate sodium which your body absorbs. This could make your treatment less effective.
- Eating a well-balanced diet and taking regular exercise can help your bones stay strong. Remember to follow any exercise or dietary advice your doctor gives to you.
- Chemicals from tobacco can get into your bloodstream and can affect your bones, making bone loss worse. If you smoke, you should make every effort to stop. Ask your doctor or pharmacist for advice on stopping.
Can risedronate sodium cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with risedronate sodium. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Common risedronate sodium side-effects (these affect less than 1 in 10 people)||What can I do if I experience this?|
|Indigestion, feeling sick, stomach ache||Stick to simple foods - avoid fatty or spicy meals|
|Diarrhoea||Drink plenty of water to replace lost fluids|
|Constipation||Try to eat a well-balanced diet and drink several glasses of water each day|
|Headache||Ask your pharmacist to recommend a suitable painkiller|
|Muscle and joint pains||Ask your pharmacist to recommend a suitable painkiller|
|Less common, but possibly serious side-effects||What should I do if I experience this?|
|Heartburn, pain or difficulty when you swallow||Stop taking the tablets and speak with your doctor as soon as possible - these may be signs that the tablets are irritating your throat|
|Pain in your thigh, hip, or groin||Speak with your doctor as soon as possible - these may be signs of a thigh bone fracture|
|A loose tooth, or jaw pain with swelling or numbness||Speak with your doctor as soon as possible - these may be signs of a problem called osteonecrosis of the jaw|
|Ear pain, discharge from an ear, ear infection||These could be signs of a problem called osteonecrosis of the ear. Speak with your doctor straightaway|
If you experience any other symptoms which you think may be due to the tablets, speak with your doctor or pharmacist for further advice.
How to store risedronate sodium
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital at once. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading & references
- Manufacturer's PIL, Actonel® 5 mg film-coated tablets; Warner Chilcott UK Limited, The electronic Medicines Compendium. Dated January 2016.
- Manufacturer's PIL, Actonel® 30 mg Film Coated Tablets; Warner Chilcott UK Limited, The electronic Medicines Compendium. Dated December 2015.
- Manufacturer's PIL, Actonel® Once a Week 35 mg film-coated tablets; Warner Chilcott UK Limited, The electronic Medicines Compendium. Dated December 2015.
- Manufacturer's PIL, Actonel® Combi film-coated tablets + effervescent granules; Warner Chilcott UK Limited, The electronic Medicines Compendium. Dated December 2015.
- British National Formulary; 71st Edition (Mar-Sep 2016) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but makes no warranty as to its accuracy. Consult a doctor or other healthcare professional for diagnosis and treatment of medical conditions. For details see our conditions.
Dr John Cox