Alendronic acid tablets šŸ˜ : Iā€™ve been taking these... - PMRGCAuk

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Alendronic acid tablets šŸ˜ 

Cfmad298601 profile image
ā€¢68 Replies

Iā€™ve been taking these for a few months and understand that they have to be swallowed properly, and whilst upright, as they can cause problems in the oesophagus.

Does anyone one else struggle with these blooming things, even with loads of water etc.

Why oh why do they have to be the size of a horse pill - Iā€™m really struggling recentlyā€¦ā€¦ā€¦canā€™t they make them smaller and you just take more of them?

The ones theyā€™ve supplied recently are huge and a strange shape, with angular sides, like a flat oval.

No matter what I do they ā€œfeelā€ stuck in my throat and youā€™re also not supposed to take with anything else and on an empty stomachā€¦ā€¦.

Iā€™ve drunk so much water Iā€™m fit to burst!

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Cfmad298601
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PMRpro profile image
PMRproAmbassador

Just say no!!! There are alternatives - not that the risendronate tablet sounds any better at 13 by 6mm which is the same size as your oval AA. Even I would struggle with those,

There are other options that don't require swallowing horse pills - you can have an annual infusion.

DorsetLady profile image
DorsetLadyPMRGCAuk volunteer

Have to say, never had a problem.

Unfortunately the tablets cannot be cut, perhaps you could get a different brandā€¦but if they really are an issue maybe discuss infusions rather than tablets with your doctor.

Do you really need to take them?

Cfmad298601 profile image
Cfmad298601ā€¢ in reply toDorsetLady

I mentioned a dexa scan a few weeks ago to my Rheumy but it was just sort of dismissed, by saying the AA would make sure I wasnā€™t lacking, I even offered to pay for the scan!

DorsetLady profile image
DorsetLadyPMRGCAuk volunteerā€¢ in reply toCfmad298601

Well in the case Iā€™d refuse to take them until you know you actually need themā€¦.many manage their bone health with VitD/Calcium supplementsā€¦

Retallack profile image
Retallackā€¢ in reply toCfmad298601

That is terrible. I was given AA at the start of PMR as "this is what we do" said the GP. When I realised that this actually wasn't the case from this wonderful forum i requested a Dexascan through my GP. The results were good and I immediately stopped the AA and on my recent second scan 2 years later my results are still good. So, ask your GP to refer you ? Good luck.

Bridge31 profile image
Bridge31ā€¢ in reply toCfmad298601

Why wonā€™t they listen ? Refuse to take them until you have had a scan. If your Rheumy wonā€™t authorise one can you ask your GP instead ? I requested one with an only a phone call from my GP. Good luck.

Suffererc profile image
Sufferercā€¢ in reply toCfmad298601

Thought a point of the DEXA was making sure AA doing itā€™s job after the first scan. I refused AA and was given a DEXA . My results no change from the last DEXA and only taken AA for a few weeks. So AA not really proof of anything

Purplegloss profile image
Purpleglossā€¢ in reply toCfmad298601

If you are able to pay for a Dexascan then you don't need a referral for it from rheumy or GP. I have just booked one at The Nuffield Hospital without a referral cost is Ā£215. I guess this may vary where ever you go.

Oh-my profile image
Oh-myā€¢ in reply toCfmad298601

I was given a prescription out of the blue for AA and calcium supplements - different GP (my GP gave me a diet sheet on sources of calcium). Decided to have a DEXA scan first (waiting results). Paid for it myself at a Nuffield Hospital. It was Ā£165 but they did request a GP referral first.

Thirkelly profile image
Thirkelly

You are quite right, they are exactly the shape you describe and with a matte finish!

Cfmad298601 profile image
Cfmad298601ā€¢ in reply toThirkelly

For something that is supposed to be properly swallowed, I donā€™t understand why the pills are made the most ridiculous size and shape everā€¦ā€¦

LucilleG profile image
LucilleG

I take an Apo-Risedronate Delayed-Release Tablet (35 mg) once a week and take it in the morning after breakfast with a large glass of water. The tablets aren't that large at all.

Songbird69 profile image
Songbird69ā€¢ in reply toLucilleG

Iā€™m going to need something as my bone mass has dropped massively in the last two years due to malabsorption issues.

Interested in knowing more about what you are taking. Does the delayed release mean it effectively bypasses the stomach?

LucilleG profile image
LucilleGā€¢ in reply toSongbird69

I just found this article: Efficacy and safety of a novel delayed-release risedronate 35 mg once-a-week tablet

ncbi.nlm.nih.gov/pmc/articl...

"The 35 mg once-a-week enteric-coated tablet delivers risedronate to sites beyond the stomach where concentrations of substances that interfere with its absorption are lower. In addition, a chelating agent included in the formulation competitively binds cations such as calcium that may be present in the area of absorption. This new DR formulation eliminates the restriction to take risedronate prior to the first food or drink in the morning and ensures adequate bioavailability and pharmacological availability of risedronate."

Songbird69 profile image
Songbird69ā€¢ in reply toLucilleG

Thank you. Thatā€™s really helpful. Are you in the U.K.? I canā€™t see if we can be prescribed this here but hoping we can.

LucilleG profile image
LucilleGā€¢ in reply toSongbird69

Iā€™m in Canada.

Songbird69 profile image
Songbird69ā€¢ in reply toLucilleG

Bet we canā€™t get them here. Iā€™m going to ask though. Thank you. Glad I spotted your post.

DorsetLady profile image
DorsetLadyPMRGCAuk volunteerā€¢ in reply toSongbird69

Looks like it according to this - unless local rules deny you -

bnf.nice.org.uk/drugs/rised...

Songbird69 profile image
Songbird69ā€¢ in reply toDorsetLady

Thank you. Canā€™t see the Gastro resistant one though? I couid be going mad of course.

DorsetLady profile image
DorsetLadyPMRGCAuk volunteerā€¢ in reply toSongbird69

Not youā€¦ maybe cannot get them in UK. Maybe be too expensive or not authorised by NICEā€¦

Songbird69 profile image
Songbird69ā€¢ in reply toDorsetLady

Maybe there is a way to get hold of them, somehow. More research needed on my part!

DorsetLady profile image
DorsetLadyPMRGCAuk volunteerā€¢ in reply toSongbird69

Perhaps try ring ROS helpline -

theros.org.uk/information-a...

- and let us know outcome, be useful for othersā€¦

Songbird69 profile image
Songbird69ā€¢ in reply toDorsetLady

Thank you. Will certainly report back.

Songbird69 profile image
Songbird69ā€¢ in reply toDorsetLady

Just a quick update. It seems that the Gastro costed risendronate is not available on the NHS. What a pity.

DorsetLady profile image
DorsetLadyPMRGCAuk volunteerā€¢ in reply toSongbird69

Yes it is.. sorry to hear that..back to the drawing boardā€¦

PMRpro profile image
PMRproAmbassadorā€¢ in reply toLucilleG

They are designed to be taken WITH food - and I find that is a lot easier.

PMRpro profile image
PMRproAmbassadorā€¢ in reply toPMRpro

Yes, they are released lower in the GI tract.

Bluey-1 profile image
Bluey-1

Tell your doc youā€™re having problems with these. I never got on with them and had stomach issues as well. If you need one the annual infusion is less intrusive to your life.

Paulagcl profile image
Paulagcl

Have you asked the pharmacist if you can cut or crush them?

DorsetLady profile image
DorsetLadyPMRGCAuk volunteerā€¢ in reply toPaulagcl

Most of the paperwork says noā€¦.

PMRpro profile image
PMRproAmbassadorā€¢ in reply toPaulagcl

Absolutely not.

ouh.nhs.uk/patient-guide/le...

If the tablets are cut or crushed it puts the patient at risk of the adverse effects to taking protocol is designed to avoid. All leaflets say "Never chew, crush or suck the tablet as this can cause side effects such as mouth ulcers and heartburn."

GwenTheHen16 profile image
GwenTheHen16

I too was prescribed these st the start of my diagnosis and totally agree with what you have said about them! I havenā€™t been offered any scans so have no idea what my bones are like!

Pedro955 profile image
Pedro955ā€¢ in reply toGwenTheHen16

My GP refused to order a scan, so I asked my rheumatologist and she arranged without a problem.

Smithie49 profile image
Smithie49

You have my sympathy as I struggle to swallow any large pill. I refused to take bisphonates even though my GP automatically tried to push them onto me once I started steroids for PMR. I have a poor result from my DEXA scan but now take vit D3 with K2 daily, Mg once a week and eat loads of Ca rich food. I jog around the house, walk, play a bit of tennis dig, do yoga and generally try to keep fit. I'm 74. I do not like the way the medics here push these pills on to us. Good luck

Lonsdalelass profile image
Lonsdalelassā€¢ in reply toSmithie49

I'm just the same Smithie49 and take same as you.....by Mg do you mean magnesium? I take one of those daily not weekly.

Smithie49 profile image
Smithie49ā€¢ in reply toLonsdalelass

Hi Lonsdalelass. Yes, magnesium. I've reduced it from daily just because I've now been given methotrexate and folic acid (both weekly doses) and I felt my poor body had enough to cope with!!!! Irrational? Well, I'm allowed that I'm old šŸ˜€ šŸ˜€

Lonsdalelass profile image
Lonsdalelassā€¢ in reply toSmithie49

Not old, just a little well worn šŸ˜€. Good luck with the methotrexate. Happy new year.

Smithie49 profile image
Smithie49ā€¢ in reply toLonsdalelass

I am very very dubious but felt I had to take some of my rheumy's advice or there was no point in seeing her.

Blossom20 profile image
Blossom20ā€¢ in reply toSmithie49

Great! I do the same. I fell off my bike about 6 months ago and didn't break anything....so hoping my bones are OK!I've read a lot about taking calcium isnt good for you - can't remember exactly why....but D3 and k2 plus weight bearing exercise are good.

PMRpro profile image
PMRproAmbassadorā€¢ in reply toBlossom20

Dietary calcium is usually fine, supplemental calcium less so.

Blossom20 profile image
Blossom20ā€¢ in reply toPMRpro

Oh, yes, I meant supplements...

Smithie49 profile image
Smithie49ā€¢ in reply toBlossom20

I only have calcium 8n my diet - lots of fat free natural yoghurt and skinny lattes. I think that's ok, it's the Ca tablets that can be tricky - I hope!!!

Indigo2417 profile image
Indigo2417

I have noticed that it depends on what brand you get. For example, at the moment Iā€™ve got Accord, which are a bit like flattened rugby balls and they take a bit of swallowing, but Teva brand are smaller and are easier. Iā€™ve tried asking the pharmacist if I can have smaller ones, but it depends on what supplies they can get. We had a shortage in 2022 and I ended up with the ones that you dissolve in water. Maybe you can have a word with your pharmacist and see if they can help.

Thelmarina profile image
Thelmarina

I changed to Ibandronic acid which you take once a month, rather than weekly Alendronic acid which I found intrusive and annoying! The capsule is a bit bulky as you describe but the shape is simple! Hope this helps šŸ˜€

Suffererc profile image
Sufferercā€¢ in reply toThelmarina

I had ibandrolic for a while but made me very depressed. Hopefully will be off steroids in a few weeks . Only on .5 but taking very slowly. Sure my GP will say just stop ā€¦ā€¦

DAW28 profile image
DAW28

I was unable to swallow the tablets when I was prescribed them. I agree with your description of 'horse pills'. I was given Zolendronate infusions instead. These were given in hospital once a year and I had no problem with them at all. Hope this is helpful.

rosie_jones profile image
rosie_jones

I don't know whether or not this will help until such time as you get an alternative, but I take my alendronic acid tablets using a tip I learned here on the forum. I take a large sip of water, keep it in my mouth, then add the tablet and a further large sip of water and the whole lot goes down together. Seems to work for me. I also use it for my prednisolone tablets so I don't get the horrible taste. Good Luck!

Tiggy70 profile image
Tiggy70ā€¢ in reply torosie_jones

Thatā€™s the method I use for swallowing my enormous 750mg Metformin tablets. So far I havenā€™t had any issuesšŸ¤—

Daffodilia profile image
Daffodilia

Cut in half and take with large glass of water?

DorsetLady profile image
DorsetLadyPMRGCAuk volunteerā€¢ in reply toDaffodilia

Cannot be cut....

Daffodilia profile image
Daffodiliaā€¢ in reply toDorsetLady

Why is that?

DorsetLady profile image
DorsetLadyPMRGCAuk volunteerā€¢ in reply toDaffodilia

See this -

ouh.nhs.uk/patient-guide/le...

Can damage oesophagus as mentioned below

Daffodilia profile image
Daffodiliaā€¢ in reply toDorsetLady

Thought that was what the water was for

DorsetLady profile image
DorsetLadyPMRGCAuk volunteerā€¢ in reply toDaffodilia

It is, but still doesnā€™t recommend cutting, chewing them -

However, there are options - which is what I suggested originally. As the old unPC saying goes- there is more than one way to skin a catā€¦.

PamJCam profile image
PamJCam

I was taking AA a few years ago as I have PMR and the doctors definitely throw all these at you whether youā€™ve had a bone scan or notā€¦. I totally agree with you how difficult they were to take but I was very studious in how I took them until about 18 months in I had a terrible episode with themā€¦actually thought I was dying/having a heart attack the pain was unbelievablešŸ˜¢ I immediately stopped taking them and got to see a consultant who did a gastroscopy and told me the tablet had burnt a hole in my oesophagusā€¦ I now have a hiatus hernia for the rest of my life unless I have surgery which isnā€™t guaranteed to work šŸ˜¢ be aware what it can do to youā€¦.and I absolutely followed the directions to the letterā€¦

Smithie49 profile image
Smithie49ā€¢ in reply toPamJCam

That's awful and not the only really negative reaction I've heard about this stuff.

DorsetLady profile image
DorsetLadyPMRGCAuk volunteerā€¢ in reply toSmithie49

Which is why we always say, donā€™t take them unless you know you need them. Many doctors hand them out all too readily, and only read the first part of the paragraph.

I had GCA, so much higher doses, and because Iā€™d had a hysterectomy aged 37 more prone to osteoporosis so I took them for 4 years with no issues. But they do need to be prescribed on an individual basis - not a blanket one.

Para 6 PMR
Booklist profile image
Booklist

I hate my AA tablets. I don't like cold water and I'm convinced that the tablet will stick in my oesophagus and do harm. Friday is ff day for me and I'm so glad that it's done for this week.

Miacaro45 profile image
Miacaro45

My cousin ( who has osteoporosis) had the same problem you have. Her endocrinologist told her to take the horse pill with a small amount of applesauce. Then, drink at least 10 ounces of water ( all done while standing or sitting up).

Gladys911 profile image
Gladys911

Hi - I had some very small tablets originally from the hospital which were easy to swallow. Since then my GP has been prescribing "Alendronic acid 70mg effervescent tablets sugar free" which dissolve in water so are also easy to take. Not sure whether you can get these but worth asking. I agree that the process is daunting when you think you might add to your problems by damaging your oesophagus. My Sunday mornings start with me drinking the AA and then trying to find things to do for half an hour... the house is tidier!

Dancingqueen77 profile image
Dancingqueen77

AA didnā€™t agree with me, so I stopped them and the hospital prescribed Binosto (dissolved in water) tastes like a fizzy drink. No problems and Iā€™ve been taking them for nearly a year. You canā€™t eat before or for half hour after.

Gladys911 profile image
Gladys911ā€¢ in reply toDancingqueen77

Thanks Dancing Queen you reminded me - Binosto is the name of the tablets I mentioned - I too have had no problems with them.

Exflex profile image
Exflex

Are the Drs (and hence you) absolutely sure you need AA? Did you have a thorough dental check up prior?

I was put on AA and swallowed the tablet for 3 years as I was completely ignorant to the downsides. I simply thought it was part of the treatment. The wise ones here tell us to have a DEXA scan before agreeing to AA, or one of itā€™s stable mates, eg Risedronate.

Suffererc profile image
Suffererc

yes. Agree they get stuck

Paulx222 profile image
Paulx222

Just been prescribed these.....having doubts about starting them now...

catdance profile image
catdance

I was prescribed alendronate, medium, flat, football shaped tablets. I took one but after reading the side effects decided I really didn't want to take them at all. I had some pretty major dental work, implants so was told not to take them. I was glad that I didn't have to argue the point. I had been taking a calcium, magnesium, zinc supplement, with all 3, along with vitamin D3, I learned from here I should be taking Vitamin K2 as well, so I did. Then just before my last rheumatologist appt I upped my vitamin D3 and found that I was taking the wrong Vit K2. I was taking MK4 instead of MK7. My rheumy approved since I was having a mild breakout of psoriasis. She never asked how much I was taking. Sooo....a couple of months later and recent, I had an appt with my Bone Dr. about the dexa scan and she called and said she had some concerns about the Vit D test, it was quite high. Well, I had been feeling pretty good! Close to how I felt when I first started on the Pred! I had done more research, finding that several Dr.s were recommending higher doses for autoimmune diseases due to the studies showing great improvement notably for MS but others as well! The recommendation is 10,000 to 40,000 IUs. I was only taking 7000 IUs. My test showed my levels were over 120 ng/mL. OK but the University of California is doing a study that suggests the normal levels should be bumped up to 150 ng/mL. She only cut my dose down to 5000 IU what I was taking that included the Vit K2 MK7. She had heard about the results on MS. The reasoning behind the higher doses being necessary is that because people with AD show that they may have VDR Resistance therefore they need the higher dose to push the levels. Of course they also recommend Mag and Zinc as well. Also, yet another interesting fact, Vitamin D3 is not actually a vitamin but a hormone, technically a steroid! The studies and other information I came across were from University of CA, University of Conn, Mayo Clinic and the Dr who was predominant in this field was Dr. Michael F. Holick, University of Boston. I currently have a diagnosis of Osteopenia that was Osteoperosis with improvement in my hips, no change in my spine but could be due to the reduction in the estrogen portion of the HRT. She is planning testing my Vit D3 levels in a few months & checking to see if she can test for the VDR resistance. I have also been told to take the calcium supplement of 1200mg daily as well. I'm wondering if anyone else has seen anything on these studies or anything at all about higher doses of Vit D3? Yes there is a risk factor of hypercalcemia but according to the studies, the only people that ended up with that or any other issues were taking 100,000 IUs for 6 months or more and it was just a few people out of thousands. I'm not a Dr nor am I recommending anyone try this without consulting your Dr first and getting your Vitamin D levels checked to see if you even need this.

Cliford37 profile image
Cliford37

Ohh i feel your pain...ive been taking them for over 5 years...i was told that after 5 years we must have a break from them....so i got excited on my visit to the doctor to hopefully be told alendroniv tablet was finishing......BUT NO.....its now advised we carry on taking them....ggrrrr....YES i so agree the shape is so unnecessarily made...i dread fridays when i take them....and more importantly NO MORNING CUPPA.....šŸ¤Ø

Rebsy profile image
Rebsy

I refused to take the AA tablets - such a faf! I pushed for a yearly zolendronic acid infusion- Iā€™ve just had my second and no ill effects. My consultant tried to put me off but all I thought was that they wanted to save money and were not thinking about my needs. If you need to take AA itā€™s definitely preferable.

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