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Bisphosphonate counselling — GPhC CRA MCQ

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ModerateMusculoskeletal TherapeuticsBisphosphonate counsellingGPhC CRA

A 72-year-old woman prescribed alendronic acid 70mg once weekly asks how to take it. She has reflux controlled with a PPI and takes calcium carbonate after breakfast. She sometimes struggles to remain upright because of morning dizziness. What would you advise the patient?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — take it on waking with plain water and remain upright for at least 30 minutes before food or other medicines

Alendronic acid must be taken with plain water on an empty stomach, with the patient remaining upright to reduce oesophageal irritation and improve absorption. Food, calcium and many other medicines reduce absorption. Difficulty remaining upright is clinically relevant and may require prescriber review of suitability. Crushing or bedtime administration increases the risk of oesophageal adverse effects.

Reference: BNF; NICE CKS: Osteoporosis