Risedronate

Sounds like 'riss-ED-row-nate'

Key points about risedronate

  • Risedronate is used to treat and prevent conditions affecting bones such as osteoporosis.
  • Risedronate is also called Actonel.
  • Find out how to take it safely and possible side effects.
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Risedronate is used to treat osteoporosis. Osteoporosis is a condition that causes your bones to be thinner and weaker than normal. This means that they can break (fracture) easily, such as after a small bump or fall. In osteoporosis risedronate prevents bone loss, increases bone thickness and lowers your risk of spine and hip fractures. It belongs to a group of medicines known as bisphosphonates. In New Zealand risedronate is available as tablets.

(RheumInfo(external link), 2019)

Note: this video is from Canada so may have information that differs from New Zealand recommendations. In New Zealand, risedronate is available as 35 mg tablets that is taken once a week. It is NOT available as 100 mg tablets.

  • The usual dose of risedronate is 1 tablet ONCE A WEEK (every 7 days).
  • Always take your risedronate exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much risedronate to take, how often to take it, and any special instructions.

It is very important that you carefully follow the instructions of how to take risedronate safely. If not taken properly, risedronate can irritate or burn the food pipe (or oesophagus).  

  • Take risedronate on the same day each week. To help you remember choose a day that best suits your routine, for example every Monday.
  • Take risedronate first thing in the morning, before eating or drinking anything else, including other medicines.
  • Do not take risedronate at bedtime or while lying in bed.
  • Take risedronate with a full glass of water.
  • Do not take your risedronate tablet with mineral water, tea, coffee, milk or juice, as these interfere with the absorption of risedronate into your body.
  • Swallow the tablet whole — do not crush or chew. Mouth ulcers may occur if the tablet is chewed or dissolved in the mouth.
  • Stay upright for at least 30 minutes after taking risedronate. Do not lie down for at least 30 minutes afterwards, and do not take any food, drinks or medicines during this time.
  • If you forget to take your risedronate, take it the next morning. Then take one tablet once a week, as usual.
  • If you are unwell and cannot sit or stand upright for 30 minutes after taking risedronate, skip that day’s dose and do not take it until you are feeling better. Contact your doctor or pharmacist if you need to miss more than two or three doses.

  • Do you have any difficulties swallowing?
  • Are you unable to sit upright for at least 30 minutes?
  • Have you had a stomach ulcer, stomach bleeding or any surgery on your upper digestive system within the last year?
  • Are planning to have any dental treatment in the near future?
  • Do you have any problems with the way your kidney works?
  • Are pregnant or breastfeeding?
  • Are you taking any other medicine (including over-the-counter and herbal products)?

If so, it’s important that you tell your doctor before you start taking risedronate. Sometimes a medicine isn’t suitable for a person with certain conditions, or it can only be used with extra care.

Like all medicines, risedronate can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Problems with your jaw

Risedronate can cause osteonecrosis of the jaw, which is a problem with the jaw, that can be caused by delayed healing in the mouth after some dental procedures. This is quite rare. To reduce the risk of this problem, it is best to:

  • Take good care of your teeth and mouth (such as brushing your teeth twice a day and regular flossing between your teeth).
  • Have regular dental check-ups.
  • Have any needed dental treatment done before you start treatment with risedronate.
  • Let your dentist know that you are having risedronate treatment. Talk to your doctor or dentist if you have any loose teeth, tooth pain, or swelling or numbness in your jaw.

Fractures

Risedronate can rarely causes fractures in your thigh bone (upper leg bone). These are called atypical fractures because they appear as cracks on the bone and are not usually related to an injury. If you have pain, weakness or discomfort in your thigh, hip or groin, tell your doctor. These pains may be warnings that there is some weakness in your bones. You may need Xrays of your legs.

Other side effects

Side effects What should I do?
  • Bloating (gas in the stomach)
  • Nausea (feeling sick)
  • Diarrhoea (loose stool)
  • These are common when you first start taking risedronate. Tell your doctor if troublesome
  • Difficulty swallowing or pain when swallowing
  • Heart burn or indigestion
  • Chest pain
  • Stop taking risedronate and tell your doctor immediately or ring HealthLine 0800 611 116
  • Eye pain
  • Red eye
  • Changes in your vision
  • Sensitive to light
  • Floating spots in your vision
  • These symptoms are related to inflammation in the eye. This is quite rare.
  • Contact your doctor immediately if you experience these symptoms. 
Read more about medicines and side effects and reporting a reaction you think might be a side effect.

Risedronate may interact with a number of medications and herbal supplements so check with your doctor or pharmacist before starting risedronate or before starting any new medicines.

References

  1. Risedronate sodium(external link) New Zealand Formulary [accessed April 2017
  2. Osteoporosis treatments and atypical femur fracture(external link) Medsafe, March 2013 
  3. Osteonecrosis: A Pain in the Jaw(external link) Medsafe Prescriber Update 33(2): 13-14 June 2012
  4. Osteonecrosis Of The Jaw And Bisphosphonates - Putting The Risk In Perspective(external link) Medsafe Publications, October 2007
  5. Reminder: Keeping an eye on bisphosphonates(external link) Medsafe Prescriber Update 32(3): 24 September 2011
  6. An update on bisphosphonates(external link) BPAC, November 2014
  7. Risedronate Sandoz(external link) Medsafe Datasheet

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Credits: Sandra Ponen, Pharmacist, Healthify He Puna Waiora. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Angela Lambie, Pharmacist, Auckland

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