If I was allergic to Alendronate won't I also be allergic to Risedronate?

[karmel]

as it is in the same group of bisphonates? I queried this with gp as I came out in hives after the couple of times I took AA. As I didn't have an anaphylactic shock he said I should try Risedronate, he didn't seem very confident that I wouldn't have hives from this when I asked him. It seems to me that gps have no choice and have to abide by certain procedures laid down by NICE. I asked about side effects if you have an intravenous injection and that doesn't seem a viable alternative.

[Met00]

It depends whether you were allergic to the actual alendronic acid or another ingredient in the tablet. You could ask if you're eligible for strontium ranelate - it's a totally different drug so might suit you better. There are other treatments otherwise, but you'd need to ask for a referral to a specialist (probably a rheumatologist).

[karmel in reply to Met00]

Thanks I didn't think of that, I just thought I had an allergic reaction to bisphonates. I'll just have to see how I am when I take Risedronate.

[trishbindefeld in reply to karmel]

I would at the very least have a chat with a nurse at the ROS. They are very helpful and knowledgable.

[karmel in reply to trishbindefeld]

I took ROS's All about osteoporosis and Bone Health to the gp, and he showed me the drug I was being prescribed. He said that I had to try another bisphonate before I could try another group. I think gps have to adhere to certain NICE guidelines when prescribing op drugs, to see if you can get on with them before prescribing another group of drug.

[Kaarina in reply to karmel]

That appears to be correct, karmel. It is to do with price. Bisphonates are the cheapest medication for OP.

[karmel in reply to Kaarina]

Yes that figures, I am sure that gps have a NICE criteria they have to follow with regard to drugs for op, which is go for the cheapest first.

[Sunseaandsand]

You would think it would be the main ingredient AA that gave the reaction.

I was told by the specialist when I had bad side effects from ibandronate that I would not necessarily have the same effects from a different bisphosphonate.

We have to keep trying to find out what is best for us.

I understand how you feel because I am very drug sensitive and it can be difficult.

[karmel in reply to Sunseaandsand]

Thanks as you say we just have keep trying to find what is best for us.

[Posy-White]

Sorry to read you are having such problems. Have you had reactions to any other foods or meds? You can have tests for reactions to proteins but as yet the tests for reactions to 'other' things are limited so you end up with a try it and see approach!

I have major problems with food intolerances, for me this means most foods and medicines. With medicines I have realised that sometimes the problem is not the main medicine but the additives that help make then more palatable and easily absorbed. You can go on line and get the patience leaflets for medicines then find the details of just what is in the medicine. It may be that it is not the core bisphonate but something else, I realise that all this is not very helpful it’s a problem I face all the time. I have found I can have one brand of a medicine but not another, in such situations it was down to the additives.

In order to try a ‘new to me’ food I was advised by the hospital to have an introduction plan. Day 1 & 2 ½ teaspoon Day 3 nothing Day 4 ½ teaspoon Day 5 1 teaspoon stopping if I had any reaction. I then continue to build on the amount. With some medicines e.g. vitamins, calcium, painkillers etc. it is safe to use this approach BUT it is not as safe without hospital support to do this method with some other medicines e.g. antibiotics.

Good luck Posy White

[karmel in reply to Posy-White]

That is a very good point because I do have intolerances to certain food groups as I have IBS. I remember one specialist was going to prescribe a certain medication and then said that it contained some sort of wheat derivative and said that won't be suitable for you and prescribed something else. But I have never had any kind of allergic reactions to anything before taking AA. So is the accompanying leaflet not as comprehensive as going on-line for all the drug's components?

[Met00 in reply to karmel]

You can find the patient information leaflet online for risedronate if you want to compare ingredients. I've copied this and you'll see, for example, that the additives include lactose, which wouldn't be suitable for anyone who is lactose intolerant:

"The active substance is risedronate sodium. Each filmcoated tablet contains 35 mg

risedronate sodium (equivalent to 32.4 mg risedronic acid).

The other ingredients are:

Tablet core: Lactose monohydrate, crospovidone, hydroxy propyl cellulose, magnesium stearate and cellulose microcrystalline.

Film coating: Hypromellose, titanium dioxide (E171), macrogol 400, hydroxy propyl cellulose, iron oxide yellow (E172), macrogol 8000, iron oxide red (E172) and silica colloidal anhydrous."

[karmel in reply to Met00]

Hi Met00, picked the Risedronate up today and have checked the leaflet with your list and as far as can see it is the same. Although the film coating lists Hypromellose, lactose monohydrate, and macrogol 400 and titanium dioxide (E171)

does not list hydroxy propyl cellulose, iron oxide yellow (E172), macrogol 8000, iron oxide red (E172) and silica colloidal anhydrous.

I don't understand why they need to add colourants; oxide yellow (E172), and oxide red (E172) - I thought it was some of these E numbers that caused side effects. Thanks for your help.

[Met00 in reply to karmel]

I'm with you all the way on that one, seems very odd to add unnecessary E numbers. I hope you get on on with it. Make sure you're not on your own when you take it for the first few weeks, just in case ...

[lawdog in reply to Posy-White]

Thank you for mentioning the additives and issues with foods. Recently I was diagnosed with EOE...if you don't know what that is, GOOD --means you don't have it. To be able to eat without choking and then upchucking a few minutes latter, I have a diet of no wheat, no diary, and no gluten. Must take an antacid before breakfast. I have discussed this new development with my doctors when any meds for other issues are rx. (Had no IDEA so many food products have wheat of some sort and that cheese is contained in so many recipes.....so no more pizza (it has all three).

[karmel]

I didn't know that the accompanying leaflet you get with a drug would differ from the patient information leaflet you get on-line. Thanks for that Met00.

[Met00 in reply to karmel]

I thought they'd be the same too! Shared the risedronate one as I didn't think you had it prescribed yet. Is it very different?

[HeronNS]

I looked back at a couple of your earlier posts and I don't know if you ever told us what your t-score is?

[karmel in reply to HeronNS]

T-score -2.9. I asked the physio her opinion of whether I could increase my bone density through exercise and supplements and not take medication. She said that with my score I needed to take medication to increase my bone density, as I wouldn't be able to increase it just through exercise.

[HeronNS in reply to karmel]

I believe your physiotherapist is wrong. I personally know someone who improved from osteoporosis level only using "natural" means. In fact she was my inspiration. And here is a link to a thread where if you scroll down you will find a reply by Aristotle. One of his t-scores was well into osteoporosis territory and he improved the natural way so medication is no longer recommended. As did I , but admittedly I was "only" in "low bone mass" range.

healthunlocked.com/pmrgcauk...

This is an account of my journey, and I believe Aristotle was also following a similar path.

healthunlocked.com/pmrgcauk...

[karmel in reply to HeronNS]

Thanks very much for echoing my own thoughts about this. I do wonder if most practitioners do not want to consider an alternative way of dealing with op. It is very worrying that the drugs for op have such terrible side effects and there is certainly no guarantee that you will not have any fractures while taking them.

[HeronNS in reply to karmel]

Were you tested to make sure you have no "secondary causes of osteoporosis"?

americanbonehealth.org/bone...

[karmel in reply to HeronNS]

I personally think that there is a secondary cause for my having osteoporosis I have IBS making me intolerant to certain carbohydrates . Years ago I asked for a gp referral to a dietitian for the low fodmap diet to help me. The dietitian said I was poorly absorbing what I was eating. About a year later I kept feeling sick and blood tests showed I had high cholesterol (heart disease runs in the family) and I had to go on a low fat diet . With both diets I had to cut back on dairy products and fat. I think my diet has played a major part in my getting osteoporosis, because no one in my immediate family has it, and I always did a lot of exercise and ate heathly. Unfortunately because, where I live, it is often difficult getting a gp's appointment (and getting a specialist referral) and gps just don't have the time (some of them don't have the inclination) to look a bit further into your medical history. IBDs, (Crohn's, ulcerative colitis and coeliac disease are recognized as being a secondary cause for getting op but not IBs. Just waiting for all the results of my blood tests to come back now.

Thanks very much for the very helpful link.

[walk21]

I know people who take AA or risedronate with no problems. I have one friend who had an injection (I don't know which) and had a bad reaction. Her consultant's comment was "If you take pills you can stop them; an injection takes six months to leave you". I think an injection is only an improvement if the bad reaction is in the digestive system. I hope you get on better with risedronate. I take strontium ranelate which is something different altogether, but not suitable for anyone with heart or circulation problems.

[karmel in reply to walk21]

When I spoke to the dr about getting an allergic reaction to bisphonates and asked if you had an injection wouldn't the side effects be worse and he agreed they would.

I am starting it tomorrow and I'll keep all you posted. I didn't come out in hives straight after taking AA it was two days later after taking it both times.

[Hidden]

karmel- I asked a Boots pharmacist what exactly a drug did and how, and further, how that could help my situation. I asked him because chances are he knows more about pharmacy than does the GP, and definitely has more time to explain. He looked online and spent some time considering it, but couldn't answer my question. Here's my point - he printed off a full page of information related to the drug and the condition it was prescribed for. It was a specialist site for prescribers. It wasn't like the patient info leaflet.

[karmel]

Hi 4thPlinth, our chemist is very helpful. I've gone on-line and checked all the info on it there and all the side effects. What do you do? it seems if you take these drugs you can still have fractures and if you don't you can have fractures. You want to make the best decision for yourself but with so many side effects to weigh up - leaves me very undecided.

[Hidden in reply to karmel]

karmel - heartfelt sympathies from me. I spent a year in that place of doubt. And I am now absolutely happy with my decision NOT to take the meds. May I just say as far as you "have to" try another bisphosphonate before changing group, the facts are otherwise: you don't have to. I was offered another. And other groups aren't better. Don't be rushed. Your doctor may not believe that your fall was due to your reaction to the drug but he has been trained to be skeptical. He should also have been trained to put your concerns to the test and if he hasn't done so, then I would be skeptical of him. The NHS is pushing these meds in the (vain) hope it will save on the billions spent on broken hips. It maybe what's causing them to break.

[karmel in reply to Hidden]

4thPlinth - I couldn't agree with you more. I think that a lot of doctors are unhappy about having to prescribe drugs knowing what the side effects are, but they do not have a choice they have to follow a certain criteria and other gp aren't. I personally think that the NHS should be testing womens' VitD and calcium levels as a matter of course be it pre-menopause or post-menopause. It would save the NHS a lot of money - and also be more pro-active regarding bone health before women have op.

[Hidden in reply to karmel]

karmel- unfortunately we don't know how much hospital trusts are 'sponsored' by pharmaceutical companies. These drugs are licensed. Vitamins are not. It would take massive reorganisation, legislation, etc to bring about such changes. And who would drive that change? So much is invested in keeping things as they are. We have to be the change we want. It'll be as good as it gets for the forseeable?

[HeronNS in reply to Hidden]

My doctor is pretty reasonable but she was much more anxious I start AA after she'd attended a workshop on osteoporosis. I've often wondered who sponsored the workshop!

[Hidden in reply to HeronNS]

HeronNS - Your healthy skepticism is the best ever medicine. It has helped me enormously. (I take it routinely now...)

[karmel in reply to Hidden]

Doctors do get bonuses for prescribing certain drugs, and unfortunately it isn't always in our best interest to take certain drugs. I think, unfortunately, supplements are also very heavily managed and often the recommended dosage is really often inadequate. Can I join the sceptics club please?

[HeronNS in reply to karmel]

I think we should all be taught more about bone health much earlier in our lives. We are told about the dangers of smoking, the importance of exercise, and given tips about a healthy diet to prevent diabetes or heart attack. It would be nice if we knew more about building a strong skeleton before we are past middle age!

[karmel in reply to HeronNS]

I think it should be mandatory Heron.

[Hidden in reply to HeronNS]

HeronNS - Very good idea. From 7 years and ongoing. With demonstration models to show every known stage of building bone, remodeling. How they work, how they fail. And encourage children to discover how difficult life would be without strong bones. Let them make models of varying strengths and test them to destruction!

Actually, I was taught in passing that bones need calcium, sunshine and exercise, but as you say, nothing about what happens if you don't get what your bones need.

[Met00 in reply to Hidden]

I knew that too, but as far as I was concerned I was getting plenty of calcium and sunshine, and a reasonable amount of exercise. In fact, though my calcium intake was good, I wasn't making enough Vit D from sunshine and was getting nowhere near enough exercise! I wish I'd known 20 years ago what I know now.

[Hidden in reply to Met00]

Met00 - me too! But I've had a number of serious health challenges in the past ten years. I wouldn't have chosen them but facing them, and the help I have had to do so, has been the most uplifting, lifechanging force that I have ever known. And I am still learning. It is concerning that 'charitable organisations can be in conflict of interest by taking sponsorship from commercial enterprise that harms us, and get away with it, but they don't matter a whole lot compared with decent values and behaviours?