Hypocalcemia; inability to stand or sit upright for at least 30 min; abnormalities of the esophagus (eg, stricture, achalasia) that delay esophageal emptying; hypersensitivity to any component of the product.
Use Cautiously in:
History of upper GI disorders.
Other disturbances of bone or mineral metabolism (correct abnormalities before initiating therapy).
Dietary deficiencies (supplemental vitamin D and calcium may be required) .
OB: Pedi: Pregnancy or children (safety not established; use in pregnancy only if potential benefit justifies potential risks).
May decrease risedronate absorption, which may decrease activity. Advise patients to take risedronate at least 30 min before any oral medications containing divalent cations.
Aspirin, NSAIDs (eg, ibuprofen, indomethacin)
NSAIDs and risedronate may be synergistic with respect to causing gastric ulcers. Use with caution. Closely monitor patients for possible GI adverse reactions, especially gastric irritation.
Food decreases absorption of risedronate immediate-release tablets compared with dosing in the fasting state. Advise patient to take risedronate immediate-release tablets at least 30 min before the first food or beverage of the day other than water. Bioavailability of risedronate delayed-release tablets is decreased approximately 30% when given immediately after a high-fat breakfast compared with administration 4 hours before a meal. The bioavailability of risedronate delayed-release tablets after a high-fat breakfast is similar to risedronate immediate-release tablets given 4 hours before a meal and approximately 2- to 4-fold greater than the immediate-release tablet administered 30 minutes prior to a high-fat breakfast. Risedronate delayed-release tablets should be taken immediately after breakfast.
These agents may affect the enteric coating on risedronate delayed-release tablets, decreasing bioavailability. Coadministration of histamine H2 antagonists or proton pump inhibitors and risedronate delayed-release tablets is not recommended.