Predisone & Risedronate DR - take at same time?

[LucilleG]

After being diagnosed with osteoporosis in my spine, I finally agreed to start taking Apo-Risedronate DR (35 mg) once a week starting in late July 2022. Because it is delayed-release tablets, I am to take them in the morning with breakfast.

I have been taking my prednisone after breakfast since May 2021. I am now tapering down to 6.5 mg from 7 mg.

When I first picked up my prescription of the Risedronate, I recall asking the pharmacist if I could take the two at the same time and they said it was fine. I started questioning this recently, so called the pharmacy tonight and spoke to another pharmacist. They told me that I should be taking the Risedronate on an empty stomach and that I should take the two medications ~2 hrs apart. I told them that there was a sticker on the package stating to "Take with food". They recommended once again to take it without food so that it would be absorbed more quickly. They also pulled up my file to see my medications.

After I got off the phone, I went online to see why the discrepancy between the advice of the two different pharmacists. What I found was that it has to do whether it is delayed-release tablets or not. The plain tablets should be taken on an empty stomach. I won't be taking the advice of the pharmacist I spoke with tonight and will continue to take the Risedronate with breakfast. (I am going to call the pharmacy again tomorrow and ask the same question, but making sure they know I'm on the delayed-release tablets.)

My question is whether I do need to be taking the two medications 2 hrs apart or if I can continue to take both of them after breakfast. For the past few months every Wednesday, I take the prednisone after I've eaten half a piece of toast with pb and jam. I then have another piece of toast with two eggs. I then take the Risedronate DR with at least one big glass of water and a cup of tea and stay standing for 30 min. I guess I'm taking the two medications ~5-10 min apart.

*Edited to add that every morning, I head out for a walk with my husband and dog ~ 7 am. We are back home and eating breakfast between 8-8.15 am. I could take the prednisone before the walk, but I'd have to eat something. I could do this once a week and then continue taking the prednisone after breakfast the other 6 days.

[DorsetLady PMRGCAuk volunteer]

Unless you are given different advice, suggest you do as per your edit … you can take Pred with a spoonful of yogurt or as you do, half a slice of toast…

[LucilleG in reply to DorsetLady]

Thank you 😀

[PMRpro Ambassador]

drugs.com/pro/risedronate-d...

includes the PIL which says:

Important Administration Instructions

Instruct patients to do the following:

• Take risedronate sodium delayed-release tablets in the morning immediately following breakfast. Risedronate sodium delayed-release tablets should be taken immediately following breakfast and not under fasting conditions because of a higher risk of abdominal pain if taken before breakfast when fasting.

• Swallow risedronate sodium delayed-release tablets whole while in an upright position and with at least 4 ounces of plain water to facilitate delivery to the stomach. Avoid lying down for 30 minutes after taking the medication [see Warnings and Precautions (5.2)].

• Do not chew, cut, or crush risedronate sodium delayed-release tablets.

Recommendations for Calcium and Vitamin D Supplementation

Instruct patients to take supplemental calcium and vitamin D if dietary intake is inadequate [see Warnings and Precautions (5.3)] and to take calcium supplements, antacids, magnesium-based supplements or laxatives, and iron preparations at a different time of the day as they interfere with the absorption of risedronate sodium delayed-release tablets.

Since the risendronate DR is to be taken immediately after breakfast and will take some time to be absorbed, on the day you take the risendronate I would wait until at least lunchtime to take the calcium supplement.

However - taking the pred shortly before the risendronate shouldn't pose a problem as it isn't the type of drug that causes problems either way.

[LucilleG in reply to PMRpro]

Thank you so much! I ended up taking my prednisone as usual, after a piece of toast with pb and jam. I then had eggs and toast and took the risendronate about 15 min after the prednisone. I take my calcium supplement, Vit D and Vit C at lunch and then again at dinner time.

[Exflex]

Can’t talk about the delayed release variant, but I’ve been on plain Risedronate for ~ two and a half years. The PIL clearly states to take before other medicine with the 1/2 hour guidance to stand or sit. About an hour later I take the Pred.

(Now I’m substantially on 2mg following the DL taper I’m relaxing the Risedronate to once a fortnight. Currently awaiting o DEXA but told it could be a l-o-n-g wait for an appointment.)

[PMRpro Ambassador in reply to Exflex]

DIfferent PIL for delayed release - see my post above.