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Alendronic acid counselling — GPhC CRA MCQ

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ModerateMusculoskeletal TherapeuticsAlendronic acid counsellingGPhC CRA

A 60-year-old woman starts alendronic acid 70mg once weekly after a fragility wrist fracture. She takes omeprazole and has difficulty swallowing large tablets, but can sit upright. Calcium is normal and eGFR is 64mL/min/1.73m2. What would you advise the patient?

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

Reveal the answer and explanation

Correct answer: D — Take alendronic acid with water on waking and remain upright before food or other medicines.

Oral bisphosphonates must be taken with plain water on an empty stomach after rising, with the patient remaining upright and avoiding food or other medicines for the required interval. Milk, calcium and food reduce absorption. Crushing may increase oesophageal irritation and is not appropriate without checking formulation guidance.

Reference: BNF; NICE CKS