OSTEOPOROSIS SECTION:  
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DRUG BRAND(S) DOSAGE SPECIAL
INSTRUCTIONS		 POSSIBLE
SIDE EFFECTS		 BE AWARE
DRUG BRAND(S) DOSAGE SPECIAL
INSTRUCTIONS		 POSSIBLE
SIDE EFFECTS		 BE AWARE
Bisphosphonates
Alendronate
Alendronate with Vitamin D
 Fosamax, Fosamax-D For corticosteroid-induced osteoporosis:
10 mg per day in women not also receiving estrogen

For postmenopausal osteoporosis and osteoporosis in men:
one 70-mg tablet or one 70-mg bottle oral solution once weekly

For osteoporosis prevention:
5 mg per day in a single dose or 35 mg per week in a single dose

Take with a full glass (8 ounces) of water first thing in the morning. Do not eat or drink anything else or take any other medication, including calcium tablets, for at least 30 minutes. Stay upright (sitting up or standing) for at least 30 minutes after taking the drug to avoid irritating the esophagus. Abdominal or stomach pain, heartburn Before taking this medication, let your doctor know if you have problems with the esophagus, stomach or kidneys. Blood levels of calcium and vitamin D must be normal before starting therapy.
Ibandronate Boniva 150 mg taken as a single monthly dose

3 mg every four months by intravenous infusion 		Take orally only with 8 ounces of water first thing in the morning. Swallow pill whole while sitting or standing; stay upright and avoid eating or taking other medicines for 60 minutes. Infusion is given at a doctor’s office. Abdominal or stomach pain; heartburn

Joint pain and fever may accompany infusions, most commonly with first infusion		 Before taking this medication orally, let your doctor know if you are taking aspirin or aspirin-containing products or if you have problems with the esophagus, stomach or kidneys. Blood levels of calcium and vitamin D must be normal before starting therapy.
Risedronate sodium
Risedronate with calcium 		Actonel, Actonel with Calcium Actonel: For treatment and prevention of osteoporosis:
single 5-mg daily dose or 35-mg once weekly (men or women)

Actonel with Calcium:
single 35-mg once-weekly Actonel tablet and six tablets that provide 500 mg calcium each

Take Actonel tablet only with water in the morning. Swallow pill whole while sitting or standing; stay upright; avoid food for 30 minutes. For Actonel with Calcium: Take one calcium tablet per day with food on days the Actonel tablet is not taken. Abdominal or stomach pain; heartburn Before taking this medication, let your doctor know if you are taking aspirin or aspirin-containing products or if you have problems with the esophagus, stomach or kidneys. Blood levels of calcium and vitamin D must be normal before starting therapy.
Hormones
Calcitonin
(nasal spray) 		Miacalcin 200 IUs per day in a single dose Refrigerate prior to opening. Prime the pump before first use. Alternate nostrils daily. Store in refrigerator after opening. Crusting, patches or sores inside the nose or other signs of nasal irritation; nosebleeds; runny nose Before taking this drug, let your doctor know if you have an allergy to Calcitonin.
Estrogens With Progesterone:
Premphase, Prempro, Activella

Estratab, Estrace, Menest

Menostar

0.625 mg per day continuously in 28-day cycles (progesterone component of drug varies depending on day of cycle)

0.3 mg to 0.6 mg per day in a single dose 1 mg

estradiol patch delivers 14 mcg estradiol per day for 7 days 		Apply patches to clean, dry skin of lower abdomen Bloating of stomach; breast pain; increased breast size; nausea; swelling of feet and lower legs; weight gain.

Increased risk of breast cancer and cardiovascular disease.

Women who have not had a hysterectomy should take estrogen in conjunction with progesterone. Before taking this drug, consult with your doctor about the possible risk of heart disease, breast or uterine cancer, blood clots and other side effects. Let your doctor know if you have liver dysfunction or disease or hypersensitivity to the medication's ingredients. Estrogens should not be used for prevention of cardiovascular disease or dementia.
Bone-Formation Agent
Parathyroid hormone (Teriparatide injection)
Forteo 20 micrograms (mcg) per day in a single dose Inject into the abdomen or thigh using a multidose, prefilled pen delivery device provided by the manufacturer. Dizziness; leg cramps Do not use if you have ever had bone cancer or radiation or if you have high blood levels of calcium; Urinary excretion of calcium should be monitored if you have urinary tract stones or a high calcium level. Should not be used in children.
Serm
Raloxifene hydrochloride Evista 60 mg per day in a single dose Take any time of day with or without food. Blood clots in veins; hot flashes; leg cramps This drug should not be used prior to menopause. It should not be used in men. Let your doctor know if there is a chance you could be pregnant or if you have a history of blood clots, or if you use cholestyramine or warafin (Coumadin).