Risendronate sodium, marketed under the brand name Actonel, is a member of a class of drugs called bisphosphonates. These agents are the first-line treatment for the prevention and treatment of osteoporosis, a bone-thinning condition characterized by low bone density and an increase in bone loss. Like most drugs, the therapeutic benefits of risendronate sodium come with potential risks or problems; however, patients can take precautions to minimize risks.
Esophageal Problems
The use of risendronate sodium may result in several disorders of the body's food tube, the esophagus. It may cause esophageal ulcers and strictures which is a narrowing or tightening of the esophagus. Esophageal perforations -- holes in the lining of the esophagus -- and esophageal erosions have all reportedly occurred in patients post-marketing of risendronate sodium. However, these serious reactions rarely occur, but when they do, they may be severe enough to require hospitalization. According to the manufacturer's prescribing information, the incidence of esophageal problems is higher in people who lie down immediately following dosing or who have difficulty swallowing the tablet. To minimize the risk for esophageal complications, the manufacturer recommends risendronate sodium be taken with 6 to 8 oz. of plain water upon rising in the morning. After dosing, the patient should remain in an upright position for at least 30 minutes. Following these instructions limits risendronate sodium's contact time with the esophagus and facilitates its delivery to the stomach.
Musculoskeletal Pain
Risendronate sodium may cause muscle pain, joint pain and back pain, according the manufacturer's prescribing information. These side effects were reported by more than 10 percent of the1,613 of clinical trial participants. Twenty-eight percent experienced back pain and 23 percent reported joint pain. Musculoskeletal side effects may be severe, and in some cases, incapacitate you. Symptoms may occur when you first start taking risendronate sodium or they may begin months later. Fortunately, they will usually resolve after you stop taking the medication.
Abdominal Side Effects
Risendronate sodium may also cause abdominal pain, diarrhea, constipation or indigestion. These side effects occurred in 12 percent,10 percent, 12 percent and 10 percent, of the 1,613 pre-marketing study participants, respectively, as noted in the manufacturer's prescribing information. None of these side effects resulted in the discontinuation of therapy with risendronate sodium. Considered minor reactions, they are manageable with over-the-counter medications. However, if your indigestion worsens or is accompanied by severe throat pain or chest pain, consult your physician and have him rule out the more serious esophageal complications.
References
- "Drug Information Handbook": Charles Lacy, RPh, Lora Armstrong, RPh., Morton Goldman, RPh. Leonard Lance, RPh.; 2008
- Epocrates Online: Risendronate Monograph
- FDA: Actonel Prescriber's Information
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