Fosamax Plus general information
What is Fosamax Plus used for?
Fosamax Plus is a combination medication used to treat osteoporosis, to reduce the risk of vertebral and hip fractures in men and postmenopausal women, and to prevent osteoporosis developing in postmenopausal women who are at risk. Osteoporosis is the loss of bone mass resulting in brittle bones which can fracture more easily and is often associated with lack of oestrogen in postmenopausal women; or following treatment with a corticosteroid, an anti-inflammatory steroid that can cause bone loss. Fosamax Plus 70/140 is used for select patients with osteoporosis who have Vitamin D deficiency and who need Vitamin D supplementation to help strengthen the bone structure making them less likely to fracture.
How does Fosamax Plus work?
Fosamax Plus tablets 70/140 contain the bisphosphonate alendronate, a synthetic chemical similar to the naturally occurring mineral in bone called pyrophosphate that mediates bone turnover, a normal part of bone remodelling and a dynamic process that allows bones to grow and repair. Alendronate acts directly on bone and binds to hydroxyapatite (the scaffolding of bone architecture), specifically at the site of bone resorption (the process for removal of old bone tissue), and inhibits the action of bone cells called osteoclasts that are responsible for bone resorption. Alendronate has no effect on osteoblast cells that are responsible for bone formation (laying down of new bone tissue). Fosamax Plus also contains cholecalciferol or Vitamin D3, a natural prohormone of the active form of Vitamin D, calcitriol (1,25-dihydroxyvitamin D3), which is a hormone involved in regulation of calcium metabolism by controlling absorption of calcium and phosphate by the intestine and their secretion by the kidneys. Calcitriol also regulates bone remodelling (bone formation and resorption). Vitamin D3 is usually synthesised in the skin by the action of sunlight on its precursor 7-Dehydrocholesterol and can also be found in the diet particularly in oily fish and eggs; it is then converted to calcitriol in two stages; first in the liver then the kidneys before being released into the circulation. A deficiency of cholecalciferol due to lack of sunlight or dietary insufficiency can disrupt calcium metabolism causing calcium imbalance and increased bone loss, which can increase risk of osteoporosis and skeletal fracture. Fosamax Plus tablets 70/140 change the balance of bone turnover so that bone breakdown is reduced relative to bone building, which increases bone mass. They also provide supplementation for Vitamin D deficiency and this combined action helps make bones stronger and more resistant to fracture, which can be painful and cause loss of height if the fracture occurs in the spine. Although alendronate in Fosamax Plus tablets 70/140 begins working on bone turnover immediately, it may take several months before measurable effects on bone mass may be seen.
What does Fosamax Plus contain?
Fosamax Plus tablets contain the active ingredients alendronate sodium (70mg), a bisphosphonate that regulates bone turnover; also cholecalciferol (140mcg) or Vitamin D3, a natural precursor of the active form of Vitamin D or calcitriol (1,25-dihydroxyvitamin D3) that regulates calcium metabolism and bone turnover and are used in combination to treat osteoporosis. They also contain Microcrystalline cellulose, lactose anhydrous, medium chain triglycerides, gelatin, croscarmellose sodium, sucrose, colloidal silicon dioxide, magnesium stearate, butylated hydroxytoluene, modified food starch, and sodium aluminum silicate.
Treating osteoporosis with Fosamax Plus
Fosamax Plus tablets 70/140 are used to treat and prevent loss of bone density in people with osteoporosis who are also deficient in Vitamin D. Fosamax Plus contains alendronate, a bisphosphonate that regulates bone turnover, and cholecalciferol or Vitamin D3, a natural precursor of the active form of Vitamin D, calcitriol (1,25-dihydroxyvitamin D3) that regulates calcium metabolism and bone turnover and are used in combination to treat osteoporosis. Bone turnover and remodelling, is a dynamic process that allows bones to grow and repair and is hormonally controlled being increased by oestrogen and decreased by corticosteroids. During menopause, oestrogen production slows down and this increases risk of osteoporosis in menopausal women, which is the loss of bone density. Aging also causes bones to weaken due to loss of bone density, so that men are also susceptible to osteoporosis. Also low levels of testosterone can cause loss of bone density. Long-term use of corticosteroid medication (an anti-inflammatory steroid) can also cause bone loss. Fosamax tablets 70/140 are used to treat osteoporosis in men and postmenopausal women and to prevent osteoporosis in pre-menopausal women who are know to be at risk of osteoporosis and who are deficient in Vitamin D and need supplementation. Fosamax Plus tablets 70/140 increase bone density and reduce the risk of vertebral and hip fractures, which can be painful and cause loss of height if the fracture occurs in the spine.
What are the side effects of Fosamax Plus?
The most commonly reported side effects when taking Fosamax Plus include: abdominal distension and pain, heartburn (dyspepsia), oesophageal ulcer, constipation, diarrhoea, flatulence, bone, muscle and/or joint pain.
When should Fosamax Plus not be used?
You should not use Fosamax Plus if you:
- are allergic to alendronate or cholecalciferol or any ingredients in Fosamax Plus
- are pregnant or are breastfeeding
- have certain disorders of the oesophagus which delay oesophageal emptying such as difficulty in swallowing (dysphagia), oesophagitis, oesophageal ulcers
- are unable to stand or sit upright for at least 30 minutes
- have low blood calcium
- are taking calcium supplements, antacids, and other oral medications will interfere with absorption of Fosamax Plus tablets 70/140, you should wait at least one half hour after taking your Fosamax Plus tablets before taking any other oral medication
- are taking aspirin, without discussion with your doctor, as this may increase risk of stomach upsets
- have kidney disease
- are using fat substitutes like olestra, mineral oil, or cholestyramine for high cholesterol as these will interfere with absorption of cholecalciferol in Fosamax Plus
- are taking medicines that interact with Fosamax Plus tablets, including: anticonvulsants, cimetidine for peptic ulcers, and thiazide diuretics
How should Fosamax Plus be taken?
You should take your Fosamax Plus tablets 70/140 one tablet per week, swallowed whole with glass of water, on the same day each week in the morning on an empty stomach at least 30 minutes before you eat or drink anything or take any other medication. You should then remain upright for at least 30 minutes, sitting, standing or walking around, to reduce risk of a reaction in your oesophagus. You should continue to take your Fosamax Plus every week for as long as recommended by your doctor, which may be several months or more, as it can take this long before you see a measurable increase in bone density.
How long should you take Fosamax Plus?
You should continue to take your Fosamax Plus tablets 70/140 every week for as long as recommended by your doctor. Although Fosamax tablets 70/140 start working on the bone cells immediately, you may not see measurable effects on bone mass for several months or more.
Missed dose of Fosamax Plus
If you miss a dose of Fosamax Plus tablets 70/140 take it on the next day; do not take a tablet on the due day if you have already have eaten or had a drink, as it will not work as well as it should. Do not take a double dose.
How should Fosamax Plus be stored?
You should store your Fosamax Plus tablets 70/140 below 25°C in a cool dry place and protect from moisture and light.