I’ve now received a diagnosis of osteoporosis in my hips and spine following a DEXA scan 6 weeks ago. I have GCA diagnosed in April 2021 and have been reducing prednisolone from 60mg to currently 6mg. My rheumatologist wants me to take alendronic acid which I’m worried about. I wonder if anyone could help with a couple of questions: do I take this before or after lansoprazole in the morning and should I delay some dental work (crown and filling), also what to expect?
I’m finding it particularly difficult to contact rheumatology or to get a GP appointment, I do absolutely understand that they are incredibly busy but do feel so isolated as I’m sure many people in our situation are.
Any guidance would be much appreciated.
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Avon14
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Do you know what your reading are ..just for interest.
IF you really need AA, it has to be taken first thing in the morning with large glass of water, and other medication 30mins after, so you need to choose a day when you have time!
Best to get dental work done before you start taking, especially if it’s anything major.
I took AA for 4 years with no issues, but it doesn’t suit everybody, so just make sure it is really required. Are you taking a VitD/calcium supplement?
Thank you for your prompt response. I don’t know the readings yet but will let you know as soon as I see them. I will choose a day, probably Sunday and take AA first thing, then 30 mins later have the lansoprazole, then 30mins later have breakfast, then prednisolone. At least it’s just once a week. I also take 1000iu vitamin D.
I need to have a crown and a filing but not sure when I’ll get an appointment.
Good to hear that you had no issues with AA. The consultant did say if it didn’t suit me there are various alternatives.
As already stated...must be taken first thing in morning on an empty stomach and at least 30mins before food or other meds. You are also advised not to lie down but stay upright as the medication can irritate the oesaphageal lining if it isn't flushed down into stomach properly...lying down can cause it to 'linger' too long in oesophagus.... hence take it with a plentiful amount of water.
I've been on it for almost 3yrs now and have had no issues so far with it. I do make sure that I take it exactly as instructed though.
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It is advised that any potentially invasive dental work is done BEFORE starting AA. It is only one day a week even with the tablets. There are other options if you have severe gastric problems - or is your lansoprozole purely prophylactic because of the high dose of pred?
Have you been given the actual results of your dexascan? I fear I am very sceptical unless I have seen the actual numbers!
Since you are now down to 6mg it is a slight case of shutting the stable door - you don't know if it is the pred or if you already had low bone density pre-pred which is always a possibility. Though if you do already have osteoporosis I do understand why the rheumy is no pushing bisphosphonates.
If you have ANY problems with swallowing or digestion then AA tablets are contraindicated. There are infusions which don't have those problems and are only once a year - saves a lot of hassle!
Hi Avon! I had AA for a year, then the GP decided it could be causing some of the indigestion, so I was put on to twice-yearly injections of Denosumab instead. It means that eventually I'll have to go back to something like AA for a while, but in the meantime, it is quite a lot more convenient. So if AA doesn't work for you, don't be backward in coming forward!
I am in a very similar situation, diagnosed with GCA May 2020. Recently diagnosed with osteoporosis following spinal fractures even though I had a good dexa scan when I started Pred. Because of oesophagus problems I didn't take AA but was offered an infusion of Zolendronic Acid which I refused as the initial scan was good. But after the fractures I had an infusion and so wish I hadn't worried about it in the first instance. Everything was fine except for a slight temperature the next day and some acid reflux. Was told full benefit would be in 6 months and a further infusion would be done in 18 months. Im sure you would not be able to take the tablets. The other thing I was told was it was mainly dental extractions that is of concern. Good luck and I hope this has helped you. Are you cared for by Bristol Hospital Avon?
Sorry to hear about your fractures, glad the infusion was okay. I’m going have a good think about how I go forward now. No I’m not in Bristol area, I’m in Buckinghamshire, Avon is anagram.
Thanks for you help, so good to know there are always people on here that are so supportive.
I too had the reservations about bisphosphonates, however went ahead. I take a monthly dose of Ibandronic acid rather than the weekly alendronic acid. I sit up for an hour doing a crossword and it’s recommended to take other medications an hour later. Just so you know about choice! 😀
Thank you. There seems to be quite a choice of meds to do the job. I think for me it’s just the unknown. So grateful for the input on this forum, so informative and helpful.
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