Drug Detail:Atelvia (Risedronate [ ris-ed-roe-nate ])
Drug Class: Bisphosphonates
1. How it works
- Atelvia is a brand (trade) name for delayed-release risedronate which may be used for the treatment or prevention of osteoporosis.
- Atelvia (risedronate) works by inhibiting osteoclasts which are responsible for breaking down and reabsorbing bone (by a process known as bone resorption). Atelvia slows down bone loss and allows osteoblasts (bone-building cells) to work more effectively, improving bone mass.
- Atelvia belongs to the class of medicines known as bisphosphonates.
2. Upsides
- Atelvia may be used to treat osteoporosis in postmenopausal women.
- Atelvia is a delayed-release tablet that is usually taken once a week.
- Strengthens bones.
- Atelvia is available as a generic under the name risedronate.
3. Downsides
If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:
- Abdominal pain, back pain, belching, cough, constipation, cramping, diarrhea, difficulty swallowing, headache, heartburn, high blood pressure, skin rash, and urinary tract infections.
- Atelvia, like other bisphosphonates, may irritate the esophagus and stomach. Some cases have been severe enough to warrant hospitalization.
- Severe bone, joint, or muscle pain, necessitating discontinuation of Atelvia in some people, has been reported, occurring from one day to several months after starting the drug.
- Rarely may cause other side effects including uveitis (eye inflammation).
- May not be suitable for some people including those with kidney disease, pre-existing esophageal conditions, low blood calcium levels (hypocalcemia), or who are unable to stand or sit upright for at least 30 minutes.
- There are concerns about the long-term safety of bisphosphonates (such as Atelvia) because long-term use has been associated with atypical femur fractures, osteonecrosis of the jaw, and esophageal cancer.
- Fracture risk reduction may also persist for years after treatment has stopped. The optimal duration of therapy with Atelvia has not been established. Periodically re-evaluate the need for therapy. Discontinuation of therapy should be considered by doctors after 3 to 5 years in patients at low risk of fracture.
- Atelvia may interact with antacids or supplements containing calcium or magnesium.
- Atelvia may lower calcium levels in the blood. Pre-existing low blood calcium levels should be corrected before Atelvia administration. Supplemental calcium or vitamin D may be required.
Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. View complete list of side effects
4. Tips
- Take Atelvia exactly as directed by your doctor. Do not increase or decrease the dosage without your doctor's advice.
- Swallow Atelvia whole, immediately after breakfast, with at least 4oz of water while in an upright position. Avoid lying down for at least 30 minutes after taking it. Do not take calcium, magnesium, or iron supplements at the same time as Atelvia. Antacids and laxatives may also affect absorption. Take these other medications a few hours later in the day.
- You may need to take supplementary calcium or vitamin D if your dietary intake is inadequate. Your doctor will advise you about this. If you are taking supplemental calcium, iron, magnesium, or antacids, take them at a different time of day to Atelvia (for example at lunchtime), as they may interfere with the absorption of Atelvia. Note that mineral water may contain a higher concentration of calcium than tap or bottled water, and you should only drink it if your doctor has confirmed it is compatible with Atelvia.
- Talk to both your dentist and doctor if you require dental surgery or tooth extraction and you have been on Atelvia long-term. They may advise discontinuation of Atelvia.
- Tell your doctor if you experience any thigh or groin pain, muscle cramps or twitches, severe or debilitating muscle pain, eye inflammation, or any other adverse effects of concern while you are taking Atelvia.
5. Response and effectiveness
- Atelvia starts to affect markers that reflect bone resorption within 14 days of treatment, reaching a maximal effect on all markers reflecting bone turnover within six months. Effects remain stable following continued treatment for up to three years.
- Food can decrease the absorption of Atelvia by up to 55%.
6. Interactions
Medicines that interact with Atelvia may either decrease its effect, affect how long it works, increase side effects, or have less of an effect when taken with Atelvia. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.
Common medications that may interact with Atelvia include:
- aluminum salts
- amikacin
- angiogenesis inhibitors, such as bevacizumab or everolimus
- aspirin
- calcium supplements
- chemotherapy agents for cancer
- diuretics, such as bumetanide and furosemide
- hormone replacement therapy
- iron salts
- lithium
- magnesium salts
- NSAIDs, such as ibuprofen, diclofenac, and naproxen
- olsalazine
- oral steroids, such as dexamethasone, prednisone, and methylprednisone
- sirolimus and tacrolimus
- zinc salts.
Note that this list is not all-inclusive and includes only common medications that may interact with Atelvia. You should refer to the prescribing information for Atelvia for a complete list of interactions.