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Pronounced: AK-ton-ell
Generic name: Risedronate

Why is this drug prescribed: Although our bones seem solid and stable, they actually undergo constant renewal. Specialized cells called osteoclasts draw used calcium out of the bones while other cells called osteoblasts replace it. Especially after menopause, this process can get out of balance. Calcium starts to leach out of the bones faster than it can be replaced, leading to the brittle-bone disease called osteoporosis. Actonel combats this problem by reducing the activity of the osteoclasts and slowing the loss of calcium from the bones. It is prescribed for postmenopausal women, both to prevent osteoporosis and to strengthen the bones once the disease has begun. It is also used to prevent or treat osteoporosis resulting from therapy with steroid medications, and it is used in the treatment of Paget's disease, a condition in which patches of bone become softened and enlarged. Both Actonel and a similar drug called Fosamax are members of the family of drugs called bisphosphonates.

Most important fact about this drug: Actonel not only stops the bone loss of osteoporosis, but actually reverses the disease and increases bone mineral density. As the bones grow stronger, your chances of sustaining a fracture decline.

How should you take this medication: Two types of Actonel are available: a 5-milligram tablet that's taken daily, and a 35-milligram tablet that's taken once a week. The tablets should be taken at least 30 minutes before the first food or drink of the day other than water. Take the pill while standing or sitting in an upright position and wash it down with a full 6 to 8 ounce glass of plain water (do not use coffee, tea, juice, milk, or other dairy products). Swallow the tablet whole, do not chew or suck on it. Do not lie down for 30 minutes after taking the medication. Other treatment measures typically include weight-bearing exercise, reduction of excessive smoking and drinking, and supplemental calcium and vitamin D if you don't get enough in your diet. If you require calcium supplements, or use any medications containing calcium, aluminum, or magnesium, avoid taking them at the same time of day as Actonel. --If you miss a dose... If you realize that you missed a daily dose and have not yet had anything to eat or drink, it's okay to take your medication. If you have already eaten, skip the dose for that day and take your regular dose the following morning. If you forget to take a weekly dose, take 1 tablet on the morning after you remember, then return to taking 1 tablet a week as originally scheduled on the chosen day. Never take 2 tablets on the same day. --Storage instructions... Store at room temperature.

What side effects may occur: Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Actonel. More common side effects may include: Abdominal pain, anxiety, back pain, belching, bladder irritation, bone disorders and pain, bronchitis, bursitis, cataracts, chest pain, colitis, constipation, depression, diarrhea, difficulty breathing, dizziness, dry eyes, eye infection, flu-like symptoms, gas, headache, high blood pressure, infection, insomnia, itching, joint disorders and pain, leg cramps, muscle pain, muscle weakness, nausea, neck pain, nerve pain, pain, pneumonia, rash, ringing in ears, sinus problems, sore throat, stomach bleeding, stuffy or runny nose, swelling, tendon problems, tumor, ulcers, urinary tract infection, vertigo, vision problems, weakness Less common side effects may include: Anemia, angina, burning or prickly sensation, dental problems, ear infection, gastrointestinal distress, heart problems, hernia, rectal problems, skin cancer, stomach inflammation, tight muscles

Why should this drug not be prescribed: Your doctor will not prescribe Actonel if you have low calcium levels in your blood or the drug gives you an allergic reaction. You also cannot take Actonel if you are unable to stand or sit upright for at least 30 minutes after taking the drug. In addition, the drug is not recommended for people with severe kidney disease.

Special warnings about this medication: The drugs in Actonel's family have been known to cause problems in the canal between the mouth and the stomach (the esophagus). Among the disorders that have been reported are esophageal irritation, difficulty swallowing, esophageal ulcers, and gastric ulcers. You can guard against such problems by taking the medication with plenty of water, swallowing the pill while standing or sitting upright, and remaining upright for 30 minutes afterwards. If you experience difficulty or pain on swallowing, chest pain, or heartburn that is severe or worse than usual, stop taking Actonel and check with your doctor immediately.

Possible food and drug interactions when taking this medication: If Actonel is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Actonel with the following: Antacids Calcium supplements Laxatives such as Milk of Magnesia

Special information if you are pregnant or breastfeeding: Actonel has caused harm when tested on pregnant animals. It is not recommended during human pregnancy unless its benefits are judged to outweigh the potential risks. If you are pregnant or plan to become pregnant, notify your doctor immediately. If you are nursing a baby, you'll need to choose between discontinuing nursing or discontinuing the drug.

Recommended dosage: Osteoporosis For the prevention and treatment of osteoporosis, the recommended dose is one 5-milligram tablet once daily or one 35-milligram tablet once a week. Steroid-Induced Osteoporosis For treatment or prevention of steroid-induced osteoporosis, the recommended dose is one 5-milligram tablet once a day. Paget's Disease The recommended dose for Paget's disease is 30 milligrams once a day for two months. A second 2-month course of therapy may be required in certain individuals.

Overdosage: A large overdose of Actonel can dramatically reduce calcium levels in the blood. Warning signs include a tingling sensation and spasms. If you suspect an overdose, seek medical attention immediately.

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