lCONTRA-INDICATIONSHypocalcaemia
lCAUTIONSAtypical femoral fractures.oesophageal
abnormalities.other factors which delay transit or
emptying (e.g. stricture or achalasia)
lINTERACTIONS→Appendix 1 : bisphosphonates
lSIDE-EFFECTS
▶UncommonGastrointestinal disorders.iritis
▶Rare or very rareGlossitis
▶Frequency not knownAmblyopia.apnoea.chest pain.
corneal lesion.dry eye.hypersensitivity.hypersensitivity
vasculitis.increased risk of infection.leg cramps.liver
disorder.muscle weakness.neoplasms.nocturia.pain.
skin reactions.tinnitus.toxic epidermal necrolysis.
weight decreased
lPREGNANCYAvoid.
lBREAST FEEDINGAvoid.
lRENAL IMPAIRMENTAvoid if estimated glomerular
filtration rate is less than 30 mL/minute/ 1. 73 m^2.
lMONITORING REQUIREMENTS
▶Correct hypocalcaemia before starting.
▶Correct other disturbances of bone and mineral
metabolism (e.g. vitamin-D deficiency) at onset of
treatment.
lDIRECTIONS FOR ADMINISTRATIONSwallow tablets whole
with full glass of water; on rising, take on an empty
stomach at least 30 minutes beforefirst food or drink of
the dayor, if taking at any other time of the day, avoid
food and drink for at least 2 hours before or after
risedronate (particularly avoid calcium-containing
products e.g. milk; also avoid iron and mineral
supplements and antacids); stand or sit upright for at least
30 minutes; do not take tablets at bedtime or before rising.
lPATIENT AND CARER ADVICEPatients or carers should be
given advice on how to administer risedronate sodium
tablets.
Medicines for Children leaflet: Risedronate for brittle
boneswww.medicinesforchildren.org.uk/risedronate-for-
brittle-bones
Oesophageal reactionsPatients should be advised to stop
taking the tablets and seek medical attention if they
develop symptoms of oesophageal irritation such as
dysphagia, pain on swallowing, retrosternal pain, or
heartburn.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: oral suspension, oral solution
Tablet
▶Risedronate sodium (Non-proprietary)
Risedronate sodium 5 mgRisedronate sodium 5 mg tablets|
28 tabletP£ 24. 78 DT = £ 18. 85
Risedronate sodium 30 mgRisedronate sodium 30 mg tablets|
28 tabletP£ 143. 95 DT = £ 143. 83
Risedronate sodium 35 mgRisedronate sodium 35 mg tablets|
4 tabletP£ 19. 12 DT = £ 0. 58
▶Actonel(Warner Chilcott UK Ltd, Teva UK Ltd)
Risedronate sodium 5 mgActonel 5 mg tablets| 28 tabletP
£ 17. 99 DT = £ 18. 85
Risedronate sodium 30 mgActonel 30 mg tablets| 28 tabletP
£ 143. 95 DT = £ 143. 83
Risedronate sodium 35 mgActonel Once a Week 35 mg tablets|
4 tabletP£ 19. 12 DT = £ 0. 58
Actonel 35 mg tablets| 4 tabletPsDT = £ 0. 58eiiiiF 468Sodium clodronate
lINDICATIONS AND DOSE
Osteoporosis (due to osteogenesis imperfecta or other
causes) (specialist use only)|Hypercalcaemia (specialist
use only)
▶BY MOUTH
▶Child:(consult local protocol)lUNLICENSED USENot licensed for use in children.
lCONTRA-INDICATIONSAcute gastro-intestinal
inflammatory conditions
lCAUTIONSAtypical femoral fractures.maintain adequate
fluid intake during treatment
lINTERACTIONS→Appendix 1 : bisphosphonates
lSIDE-EFFECTSProteinuria.respiratory disorder
lPREGNANCYAvoid.
lBREAST FEEDINGManufacturer advises avoid—no
information available.
lRENAL IMPAIRMENTAvoid if estimated glomerular
filtration rate less than 10 mL/minute/ 1. 73 m^2.
Dose adjustmentsReduce dose if estimated glomerular
filtration rate 30 — 50 mL/minute/ 1. 73 m^2.
Use half normal dose if estimated glomerularfiltration
rate 10 – 30 mL/minute/ 1. 73 m^2.
lMONITORING REQUIREMENTSMonitor renal function,
serum calcium and serum phosphate before and during
treatment.
lDIRECTIONS FOR ADMINISTRATIONAvoid food for 2 hours
before and 1 hour after treatment, particularly calcium-
containing products e.g. milk; also avoid iron and mineral
supplements and antacids; maintain adequatefluid intake.
lPATIENT AND CARER ADVICEPatients or carers should be
given advice on how to administer sodium clodronate
capsules and tablets.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug.
Tablet
CAUTIONARY AND ADVISORY LABELS 10
▶Sodium clodronate (Non-proprietary)
Sodium clodronate 800 mgSodium clodronate 800 mg tablets|
60 tabletP£ 116. 72 DT = £ 146. 43
▶Bonefos(Bayer Plc)
Sodium clodronate 800 mgBonefos 800 mg tablets|
60 tabletP£ 146. 43 DT = £ 146. 43
▶Loron(Intrapharm Laboratories Ltd)
Sodium clodronate 520 mgLoron 520 mg tablets| 60 tabletP
£ 114. 44 DT = £ 114. 44
Capsule
▶Sodium clodronate (Non-proprietary)
Sodium clodronate 400 mgSodium clodronate 400 mg capsules|
30 capsuleP£ 34. 96 | 120 capsuleP£ 139. 83 DT = £ 139. 83
▶Bonefos(Bayer Plc)
Sodium clodronate 400 mgBonefos 400 mg capsules|
120 capsuleP£ 139. 83 DT = £ 139. 83
▶Clasteon(Kent Pharmaceuticals Ltd)
Sodium clodronate 400 mgClasteon 400 mg capsules|
30 capsuleP£ 34. 96 | 120 capsuleP£ 139. 83 DT = £ 139. 83470 Disorders of bone metabolism BNFC 2018 – 2019
Endocrine system6