Experiences with

Risedronate

Risedronate (risedronate sodium) is a type of medicine called a bisphosphonate. It helps your bones stay as strong as possible.

It can help if you have or are at risk of getting a health condition called osteoporosis. This is where your bones get weaker and more likely to break.

Osteoporosis can happen for many reasons, but you're more likely to get it if you're a woman who has been through the menopause or if you take steroids, such as prednisolone, for a long time. Some types of cancer treatment can also increase your risk of getting osteoporosis.

Risedronate can also help people who have Paget's disease of bone. This weakens your bones and they can become deformed. Risedronate helps to reduce these bone changes, reduce pain and make your bones stronger and less likely to break.

Risedronate comes as tablets and is only available on prescription.

Who can take risedronate

Most adults aged 18 and over can take risedronate.

It's occasionally prescribed for children with osteoporosis.

Who may not be able to take risedronate

Risedronate is not suitable for some people. To make sure it's safe for you, tell your doctor if you:

• have ever had an allergic reaction to risedronate or any other medicine
• have digestive problems, problems swallowing or any problems with your food pipe (oesophagus)
• cannot sit up or stand for at least 30 minutes
• have low calcium levels in your blood – taking risedronate could make them even lower
• have kidney problems
• have cancer, or are having chemotherapy or radiotherapy
• have problems with your teeth, or are waiting for dental treatment such as having a tooth out
• smoke or used to smoke – this may increase your risk of dental problems
• are pregnant or breastfeeding, or trying to get pregnant

Dosage and strength

Risedronate tablets come in strengths of 5mg, 30mg and 35mg.

For Paget's disease of bone, the usual dose for adults is 30mg, taken once a day.

For osteoporosis, the usual dose for most adults is 35mg taken once a week. You may prefer to take 5mg, once a day.

How to take it

Take your medicine first thing in the morning, when you get up. Take it on an empty stomach, at least 30 minutes before you have anything to eat or drink (other than plain water) and before you take any other medicines or supplements.

It's important to take risedronate while you're sitting up or standing, so that it does not irritate or damage your food pipe (oesophagus). Stay upright for 30 minutes after taking your medicine.

Risedronate works best when your stomach is empty, so your body can absorb it properly.

If you cannot take it first thing in the morning, you can take it later in the day, but in this case do not eat or drink anything (other than plain water) or take any other medicines for 2 hours before and after taking your tablet.

Swallow the tablet whole with a large glass of plain tap water (at least 120ml). Do not chew, break, crush or suck the tablet. Do not take it with mineral water.

It's important to follow the instructions for this medicine very carefully. If you do not, it may not work, or it could irritate and damage your food pipe as you swallow it.

How long to take it for

How long you'll need to take risedronate depends on why your doctor has prescribed it.

For Paget's disease of bone, you'll usually take it for 2 months. You may need to start taking it again if your symptoms come back.

For osteoporosis, you'll usually take risedronate for a long time.

If you're having long-term treatment with steroids, you'll usually take risedronate until your steroid treatment stops, and maybe for longer.

If you have osteoporosis, your doctor will usually assess your risk of broken bones after 5 years. This may include tests to check the strength (density) of your bones.

Depending on the results, you'll either keep taking risedronate, take a break from it or stop taking it completely.

If you forget to take it

If you miss a dose, what you do next depends on how often you're supposed to take risedronate. If you usually take it:

• once a day (5mg or 30mg) – take it later in the day, but do not eat or drink anything (other than plain water) or take any other medicines or supplements by mouth for 2 hours before and 2 hours after taking the tablet. If this is not possible, then just skip the missed dose and take your next dose on the following day, in the morning
• once a week (35mg) – wait until the next day and then take your medicine first thing in the morning. After this, go back to taking your weekly dose on your usual day

Never take 2 doses to make up for a forgotten one.

If you take risedronate once a week, some packaging has a space to mark the day of the week and the dates you take your tablets. This can help you remember to take your medicine on the right day.

If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

If you take too much

If you take an extra dose of:

• your 5mg daily or 35mg weekly tablet – it's unlikely to harm you. Drink a full glass of milk immediately if you can, and stay upright for at least 30 minutes
• your 30mg daily tablet – drink a full glass of milk immediately if you can, and stay upright for at least 30 minutes

If your child takes an extra dose, get them to drink a full glass of milk immediately if possible. Contact their doctor or contact 111 straight away. Keep your child sitting up or standing for at least 30 minutes.

Do not make yourself or your child sick (vomit), as this may irritate the food pipe.

• you take more than 1 extra dose of risedronate

Go to 111.nhs.uk or call 111

If you need to go to A&E, do not drive. Ask someone to drive you or call 999 and ask for an ambulance.

Bring the risedronate packet or leaflet inside it, any remaining medicine, and any other medicines you take.

Common side effects

These common side effects of risedronate happen in more than 1 in 100 people. There are things you can do to help cope with them:

Speak to a doctor or pharmacist if the advice on how to cope does not help and a side effect is still bothering you or does not go away.

Serious side effects

Some people may have serious side effects when taking risedronate.

Tell a doctor or call 111 straight away if you have:

• heartburn (or heartburn that gets worse), or problems or pain when swallowing – these may be signs of ulcers in your food pipe. If this happens, stop taking risedronate and speak to a doctor
• a loose tooth, mouth sores, or swelling or pain in your mouth or jaw – contact your dentist as well as your doctor, as this could be a sign of damage to your jawbone
• pain, weakness or discomfort in your thigh, hip or groin – this happens rarely but may be an early sign of a broken thigh bone
• severe pain in the joints, muscles or bones
• ear pain, discharge from your ear or an ear infection – these can be signs of damage to the bones in your inner ear
• black or red poo – these can be signs of an ulcer or bleeding from your gut
• blurred vision, light sensitivity, or painful or red eyes – these can be signs of swelling of the eye
• muscle cramps or spasms, a tingling sensation in your fingers or around your mouth – these can be symptoms of low calcium levels in your blood

Serious allergic reaction

In rare cases, risedronate may cause a serious allergic reaction (anaphylaxis).

For a very small number of people, taking risedronate for more than 2 years can increase their chances of getting a rare type of bone damage in their inner ear and certain types of breaks to their thigh bones.

If risedronate is working for you long term, your doctor will look at the benefits and risks of your treatment after 5 years. They may do some tests to check the strength (density) of your bones. Then they'll advise you if you should keep taking it.

The benefits of taking risedronate generally outweigh the risks. If you're concerned or have any questions, talk to your doctor or pharmacist.

Other side effects

These are not all the side effects of risedronate. For a full list, see the leaflet inside your medicine packet.

Risedronate and pregnancy

Risedronate is not generally recommended during pregnancy because there is little information on its safety.

If you become pregnant while taking risedronate, contact your doctor or hospital specialist for advice about whether to keep taking it or not.

Risedronate and breastfeeding

If your doctor says your baby is healthy, you can take risedronate while you're breastfeeding.

It is likely that only tiny amounts will get into your breast milk which would not be expected to cause any problems in your baby.

Although it's generally OK to take this medicine while breastfeeding, it may not be suitable in a very few cases. Check with your doctor about what's best for you and your baby.

If your baby is not feeding as well as usual, is being sick or is constipated or you have any other concerns about your baby, talk to your doctor, pharmacist, health visitor or midwife.

Risedronate and fertility

There's no good evidence to suggest that taking risedronate reduces fertility in either men or women.

If you're trying to get pregnant and are taking risedronate, speak to your doctor or hospital specialist. This is because they may consider taking you off the medicine while you're trying to get pregnant.

Cautions with other medicines

When taking risedronate, it's important to not take any other medicines at the same time. This is because other medicines can affect how well your body absorbs risedronate and may stop it working properly.

If you take risedronate first thing in the morning, when you get up, wait for at least 30 minutes before taking your other medicines.

If you take risedronate between meals or in the evening, wait at least 2 hours before taking your other medicines.

Tell your doctor if you're taking:

• antacids to relieve indigestion or heartburn such as Maalox, Mucogel or Milk of Magnesia
• laxatives containing magnesium such as Milk of Magnesia
• cancer medicines such as bevacizumab or thalidomide, or if you're having chemotherapy or taking steroids such as prednisolone or dexamethasone – these may increase the risk of damage to your jawbone
• non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, which can increase the risk of irritating your food pipe, stomach or gut – taking low-dose aspirin is OK
• antibiotics such as gentamicin, amikacin, streptomycin or tobramycin – these can lower the calcium in your blood
• deferasirox, a medicine used to remove excess iron from the body – this may increase the risk of bleeding from your gut
• parathyroid hormone, a medicine used to treat hypoparathyroidism

Mixing risedronate with herbal remedies or supplements

Tell your doctor if you're taking supplements or multivitamins containing calcium, iron, magnesium or zinc. These supplements can reduce the amount of risedronate absorbed from your stomach if you take them at the same time.

If you take your risedronate in the morning, consider taking your calcium, iron, magnesium or zinc supplement in the evening.

There's not enough information to say that other complementary medicines, herbal remedies and supplements are safe to take with risedronate. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the affect they have on other medicines.

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