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Alendronate renal and oesophageal cautions — GPhC CRA MCQ

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HardRenal and Hepatic ImpairmentAlendronate renal and oesophageal cautionsGPhC CRA

A 69-year-old woman with eGFR 29mL/min/1.73m2 is prescribed alendronic acid 70mg weekly after a fragility fracture. She also has dysphagia from oesophageal stricture and takes calcium/vitamin D. The discharge summary asks the GP to continue bone protection. What is the most appropriate action?

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Correct answer: D — query alendronic acid suitability because renal impairment and oesophageal disease affect safety

Oral bisphosphonates require caution or avoidance in significant renal impairment and are unsuitable in some oesophageal disorders or swallowing problems. Dysphagia and oesophageal stricture increase the risk of oesophageal injury. The pharmacist should query suitability and ask the prescriber to consider alternatives. Chewing or taking with food would worsen administration problems and reduce absorption.

Reference: BNF; NICE CKS: Osteoporosis