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Alendronate Systematic (IUPAC) name sodium [4-amino-1-hydroxy-1-(hydroxy-oxido-phosphoryl)- butyl]phosphonic acid trihydrate Identifiers CAS number 121268-17-5 ATC code M05BA04 PubChem 2088 DrugBank APRD00561 Chemical data Formula C4H18NNaO10P2 Mol. weight 325.124 Pharmacokinetic data Bioavailability 0.6% Metabolism excreted unchanged Half life  ? Excretion renal Therapeutic considerations Pregnancy cat. ? Legal status POM (UK) Routes oral tablets Alendronate (Fosamax®, Merck) is a bisphosphonate drug used for osteoporosis and several other bone diseases. It fosamex is marketed alone as well as in combination with vitamin D (2,800 U, under the name Fosavance). Contents 1 Pharmacokinetics 2 Pharmacology 3 Uses 4 Contraindications foxamax and precautions 5 Side-effects 6 Interactions 7 Dosage 8 Dosage fosemax forms 9 Patent Remarks (USA) 10 Litigation 11 Bis-phossy Jaw 12 External links Pharmacokinetics The systemic bioavailability after oral dosing is only 0.6 fosamx % as well in women and in men (fasting state). Intake together with meals and certain drinks (coffee, orange juice) fosamaz further reduces the bioavailability. Soft tissues and bones are fastly reached by about 50%. After resorption in the bone alendronate has an estimated terminal fasamax halflife of 10 years; the remainder is excreted unchanged by the kidneys. Pharmacology Alendronate blocks osteoclast-mediated bone-resorption. It fosamaxx is chemically related to etidronate and the N-containing bisphosphonates such as pamidronate, which with it shares the same mode of action. Its inhibition of bone-resorption is dose-dependent and 100 to 1,000 fossmax times stronger than the equimolar effect of etidronate. Theoretically, alendronate may also inhibit bone-mineralization but this effect is 6,000 times weaker than the inhibition of bone-resorption. Under therapy normal bone fosama tissue develops and alendronate is deposited in the bone-matrix in pharmacologically inactive form. For optimal action enough calcium and vitamin D are needed in the body. Hypocalcemia foszmax should therefore be corrected before starting therapy.half life is 10.5years Uses Prophylaxis and treatment of female osteoporosis Treatment of fosamax male osteoporosis Prevention and treatment of corticosteroid-associated osteoporosis together with supplements of calcium and vitamin D Paget's disease Contraindications and precautions Acute inflammations of the gastrointestinal tract (esophagitis, gastritis, ulcerations) Clinically manifest fosamax side effects osteomalacia Certain malformations and malfunctions of the esophagus (strictures, achalasia) Inability to stand, walk, or sit for 30 minutes side effects from fosamax medication after oral administration Renal impairment with a creatinine clearance below 30ml/min Hypersensitivity to alendronate or another ingredient Hypocalcemia Pregnancy and breastfeeding Patients below 18 yrs. of age, because no clinical data exists Side-effects GI tract: most fosamax warnings prominent are harmless side effects such as mild nausea, dyspepsia, abdominal cramps, flatulence, diarrhea, or fosamax osteonecrosis obstipation. A severe side effect is an ulceration of the esophagus caused by alendronate, which may require hospitalization and intensive treatment. Gastric and duodenal ulceration. General: infrequent cases of skin rash, rarely manifesting as Stevens-Johnson syndrome and toxic epidermal fosamax weight gain necrolysis, eye problems (uveitis, scleritis) and generalized muscle, joint, and bone pain (rarely severe) have been seen. In laboratory tests decreased calcium and phosphate values may be obtained but reflect action of fosamax class action lawsuit the drug and are harmless. Cases of osteonecrosis of the jaw have been reported in the scientific literature.. Deterioration of fosamax jaw the TM Joint can also result while on this drug if dental work of any kind 'needs' to be done. Interactions Milk, diet and drugs containing high amounts of calcium, fosamax alendronate sodium magnesium or aluminium (antacids): the resorption of alendronate is decreased. At least half an hour should pass after fosamax long term use intake of alendronate before taking the supplement or drug. Highly active vitamin D analogues or fluorides: no data is available. Concomitant treatment should fosamax and jaw be avoided. The additional beneficial effect of HRT (hormone replacement therapy) with estrogens/progestins or raloxifene in postmenopausal hair loss from fosamax women remains to be elucidated, but no interactions have been seen. The combination is therefore possible. Intravenous ranitidine increases the oral bioavailability of alendronate. No clinical consequences are known. The combination of NSAIDS and alendroate increases the risk of gastric ulcers. negative comments on fosamax Both these drugs have the potential to irritate the upper gastro-intestinal mucosa. Dosage Prophylaxis of fosamax jaw necrosis osteoporosis in women: 5-10mg daily or 35-70mg weekly. Therapy of osteoporosis in women and men : 10mg daily or 70mg weekly. Osteoporosis under corticosteroids: 5mg daily or 35mg weekly in men and premenopausal women or those receiving concomitant HRT. In postmenopausal women not receiving fosamax litigation HRT the recommended fosamax patent dose is 10mg daily or 70mg weekly. Paget's Disease: 40mg daily for 6 months. The drug is to be taken only upon rising for the day with plenty of water. Stand, walk side effects of fosamax or sit 30 minutes afterwards to avoid esophageal damage. At least 30 minutes should be waited before meals or other beverages than water are taken in. Dosage forms Fosamax® solution utah fosamax attorneys 70mg/75ml Fosamax® tablets 5mg, 10mg, 35mg, 40mg, and 70mg Patent Remarks (USA) Its patent is set to expire in 2008 and Merck has lost a series of appeals to block a fosamax international study fosit generic version of the drug from being certified by the US FDA. Litigation On September 24, 2004 the Journal of Oral and Maxillofacial Surgeons issued a fosamax problems report prompting the generic fosamax US Food and Drug Administration (FDA) and Merck to issue a warning to health care professionals concerning Alendronate and its brand name equivalent, Fosamax. As indicated in the side-effects, Alendronate was connected to osteonecrosis of the jaw (ONJ). Product liability attorneys maintain this condition is long term use of fosamax far more widespread than initially indicated. Moreover, pending lawsuits maintain claimants' ONJ is a direct result of luxury hotel rome fosamax the use of Alendronate, while Merck has stated the "underlying cause" of osteonecrosis salt lake city fosamax attorneys of the jaw is "uncertain," though it might be triggered by a traumatic event like tooth extraction or oral surgery. Plaintiffs claim that the tooth extraction and oral surgery wouldn't be a problem if salt lake city fosamax lawyers their jaws hadn't been damaged by the drug. As of May 2006, results of litigation have been mixed, with Merck winning 2 cases, losing 2 and receiving a split verdict on a fifth case. Difficulties facing those seeking damages utah fosamax lawyers center around the disputed connection between the drug and osteonecrosis of when did merck start advertising fosamax the jaw. Bis-phossy Jaw The term given by scientists to the link between bisphosphonates and jaw necrosis is 'bis-phossy jaw.' This is derived from the 19th-century term fosamax adverse effects phossy jaw, given its name after workers in match factories working with white phosphorous developed osteonecrosis of the jaw. External fosamax gain weight links Fosamax Information, Side Effects, ONJ etc... Fosamax information from Merck RxList page MedlinePlus listing Fosamax Side Effects Merck & Co., Inc. Corporate Directors: Lawrence Bossidy | William Bowen | Richard Clark | fosamax international study Johnnetta Cole | William Harrison fosamax mice thyroid | William Kelley | Rochelle Lazarus | Thomas Shenk | Anne Tatlock | Samuel Thier | Wendell Weeks | Peter Wendell Key products: Indinavir | Aprepitant | Alendronate | Rizatriptan | Finasteride | Montelukast bonviva instead of fosamax | Rofecoxib | Ezetimibe/simvastatin | Ezetimibe | Simvastatin | The Merck Index | The Merck Manual Annual Revenue: $22.9 billion USD fosamax + depression (2% FY 2004) | Employees: 63,000 | Stock Symbol: NYSE: MRK | Website: www.merck.com Bisphosphonates (M05A)edit Nitrogenous: Pamidronic acid, Alendronic acid, Ibandronic fosamax aciphex aciphex alphagan canada online pharmacy acid, Risedronic acid, Zoledronic acid Non-nitrogenous: Etidronic acid, Clodronic acid, Tiludronic acid Search Term: fosamax alternative "Alendronate" Categories: Bisphosphonates | Merck fosamax infusion