CNS: Headache (3%); malaise (postmarketing).
DERM: Pruritus, rash (occasionally with photosensitivity), severe skin reactions including Stevens-Johnson syndrome and toxic epidermal necrolysis (postmarketing).
EENT: Episcleritis, scleritis, uveitis (postmarketing).
GI: Abdominal pain (7%); acid regurgitation, flatulence (4%); constipation, diarrhea, dyspepsia, nausea (3%); esophageal ulcer (2%); abdominal distention, dysphagia, gastric ulcer, gastritis (1%); duodenal ulcer, esophagitis, esophageal erosion, esophageal stricture or perforation, oropharyngeal ulceration (postmarketing).
HYPERSEN: Hypersensitivity including urticaria, angioedema (postmarketing).
LABTESTABS: Asymptomatic, mild, and transient decreases in serum calcium (18%) and phosphate (10%); symptomatic hypocalcemia (postmarketing).
MUSC: Muscular skeletal pain (4%); muscle cramp (1%); transient myalgia (postmarketing).
OTHER: Fever (postmarketing).
Risk of upper GI adverse reactions is increased by concomitant use of aspirin and alendronate doses over 10 mg/day.
Calcium supplements, antacids, other cations
Decreased alendronate absorption.
Absorption of alendronate is decreased by food.
Beverages other than water decrease absorption.
Risk of GI irritation may be increased.
Increased alendronate absorption; clinical importance unknown.
Therapeutic Classification: bone resorption inhibitors
Pharmacologic Classification: biphosphonates
Absorption: Poorly absorbed (0.6–0.8%) after oral administration.
Distribution: Transiently distributes to soft tissue, then distributes to bone.
Metabolism/Excretion: Excreted in urine.
Half-life: 10 yr (reflects release of drug from skeleton).
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