Oral Bisphosphonates
Introduction Bisphosphonates (antiresorptive medications) are first-line therapy used for prevention and treatment of osteoporosis . Options include alendronate (oral), ibandronic acid (oral or IV), pamidronate (IV), risedronate (oral), zoledronic acid (IV). Oral Dosage Alendronate: 10 mg daily or 70 mg once a week Ibandronic acid: 150 mg once monthly Risedronate: 5 mg daily or 35 mg once a week or 150 mg once monthly Method of Administration Oral bisphosphonates bioavailability is less than 1% and is greatly decreased with concomitant food and beverages. Each oral tablet should be taken in the morning with at least 6 oz (180 ml) of plain water (not coffee, juice, mineral water, or milk) at least 30 minutes (60 minutes for oral ibandronate) before consuming any food, supplements, or medications. An exception is delayed-release risedronate, which is administered immediately after breakfast with at least 4 oz (120 ml) of plain water. Missed Dose Management If patient misses a weekl...