The Medical Letter on Drugs and Therapeutics
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Monthly Risedronate (Actonel) for Postmenopausal Osteoporosis

The bisphosphonate risedronate (Actonel – Procter & Gamble) was recently approved by the FDA in a 150-mg once-monthly oral tablet for prevention and treatment of postmenopausal osteoporosis. The drug is also available for the same indication in 5-mg daily, 35-mg weekly and 75-mg twice-monthly tablets.

BISPHOSPHONATES FOR OSTEOPOROSIS — Risedronate, alendronate (Fosamax, and others) and ibandronate (Boniva) are bisphosphonates approved for oral treatment and/or prevention of osteoporosis. Ibandronate is the only other bisphosphonate available in a tablet given once monthly.1 Oral bisphosphonates can cause heartburn, esophageal irritation and esophagitis. To ensure adequate absorption (at best <1% is absorbed) and avoid esophageal injury, they require a regimen that some patients find difficult. The drug must be taken with 8 ounces of plain water after an overnight ... more      

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