risedronate sodium: clinical use

Prescribing considerations

• Correct hypocalcaemia and address vitamin D or other mineral-metabolism disorders before treatment.
• Assess the ability to follow fasting and upright-administration instructions.
• Use caution with oesophageal transit disorders, Barrett’s oesophagus, or active or recent upper gastrointestinal disease.
• Assess oral health and osteonecrosis risk factors; encourage routine dental care.
• Periodically reassess fracture risk, benefit, harms and continuing treatment need.

Contraindications and cautions

• Hypersensitivity to risedronate sodium or an excipient
• Hypocalcaemia
• Pregnancy or breastfeeding
• Severe renal impairment with creatinine clearance below 30 mL/min

Monitoring

• Renal function and calcium status before prescribing
• Vitamin D and other bone-mineral abnormalities where clinically indicated
• New oesophageal symptoms and adherence to administration technique
• Dental symptoms or delayed oral healing
• New thigh, hip or groin pain suggesting an incomplete femoral fracture

Clinical pharmacology

A pyridinyl bisphosphonate with very low oral bioavailability. It binds bone hydroxyapatite, inhibits osteoclast-mediated resorption, is not systemically metabolised, and is cleared renally or deposited in bone.

Formulation and product differences

• The selected product is a film-coated tablet that must be swallowed whole.
• It contains lactose and is described as essentially sodium-free.
• Excipients and tablet appearance may differ between manufacturers; check the relevant product information.

Tablet

Route: Oral

Strengths: 5 mg, 30 mg, 35 mg