On the part of the organ of hearing and labyrinth disorders common: vertigo . On the part of the gastrointestinal tract often: abdominal pain, dyspepsia (constipation or diarrhea, flatulence), dysphagia, heartburn; rare: nausea, vomiting, esophagitis, gastritis, ulceration of the esophageal mucosa, melena, rarely esophageal stricture, ulceration of the mucous membranes of the mouth, throat, stomach, and 12 duodenal trenbolone ulcer, bleeding from the upper gastrointestinal tract, perforation of the esophagus. skin and subcutaneous tissue disorders common: alopecia, pruritus of the skin; rare: rash, redness of the skin; rare: increased photosensitivity, severe skin reactions, including Stevens-Johnson syndrome (malignant exudative erythema) and toxic epidermal necrolysis (toxic epidermal necrolysis) syndrome.
On the part of the musculoskeletal and connective tissue is very common: pain in the muscles, bones, joints, often: severe pain in the muscles, bones and joints, swelling of the joints; rarely,osteonecrosis of the jaw (see. See “Special Instructions”), atypical fractures of the proximal femoral shaft. General disorders and injection site common: asthenia, peripheral edema Uncommon: transient flu-like symptoms (muscle pain, fatigue, rarely fever), typically occurring at the beginning of therapy.
Against the background of the drug overdose may develop hypocalcemia, hypophosphatemia, and symptoms such as abdominal pain, dyspepsia, dysphagia, heartburn, esophagitis, gastritis, ulceration of the mucous membrane of the gastrointestinal tract. Treatment: symptomatic. The application of milk and antacids to bind alendronate. Due to the risk of injury of the esophagus should not induce vomiting, the patient must be in an upright position.
Interaction with other drugs
Concomitant use of calcium supplements (including dietary supplements) and antacids affects the absorption of alendronate. In this regard, it is recommended to take other drugs, not earlier than 30 minutes after application Foroza preparation ® .
Nonsteroidal anti-inflammatory drugs (including aspirin) may increase side alendronic acid action on the mucous membrane of the gastrointestinal tract.
In spite of the fact that special research on drug interactions has been conducted, the use of alendronate in clinical trials with a large number of widely used drugs was not associated with the development of clinically significant interaction.
in clinical studies in patients taking estrogen drugs (intravaginally, transdermally or orally) simultaneously with alendronate, there was no evidence of clinically significant interaction.
To wash down pills trenbolone should only plain water as other drinks (including mineral water, tea, coffee, fruit juices) impair the absorption of the drug. Receiving alendronate at bedtime or in the horizontal position increases the risk of esophagitis.
If you have symptoms of esophageal irritation such as dysphagia, chest pain or the occurrence / worsening of existing heartburn patients should see a doctor to assess the possibility of extending the treatment.
The risk of serious adverse effects from esophageal higher in patients taking alendronate in violation of the instructions and / or continue to receive it after the onset of symptoms indicative of oesophageal irritation. It is important to explain in detail the rights of patients taking the drug, and to make sure that he understood them. Patients should be aware of the increased risk of adverse events on the part of the esophagus in the case of deviations from the requirements of the instructions.
Before starting therapy w requires correction of hypocalcemia and other metabolic disorders (such as lack of vitamin D). In connection with an increase of alendronic acid therapy in bone mineral density will be a slight reduction in clinically asymptomatic calcium and phosphate levels in the serum, especially in patients receiving glucocorticoids in which the absorption of calcium can be reduced.Therefore, it is important to ensure a sufficient amount of calcium and vitamin D in the body, which is particularly important in patients receiving glucocorticoids.
Patients should be warned that if you accidentally missed doses at a dosage of 1 time per week they should take one tablet in the morning the next day (not allowed to take 2 one tablet per day). In the future we should continue to take 1 tablet on the day of the week, which was selected at the beginning of therapy.
There is also information about osteonecrosis of the jaw in patients with ostoporozom receiving oral bisphosphonates. Prior to the appointment of therapy bisfosfanatami patients with concomitant risk factors (eg cancer, chemotherapy, radiotherapy, receiving glyukokortikosteriodov, poor oral hygiene, anemia, coagulopathy, infection, gum disease) need to undergo dental examination with appropriate preventive dentistry.
During treatment data patients as possible should avoid invasive dental treatment. For trenbolone patients during treatment with bisphosphonates appeared osteonecrosis of the jaw, surgical dental intervention may lead to aggravation of the state.
The data on the risk reduction potential development of osteonecrosis of the jaw after discontinuation of bisphosphonate therapy in patients requiring dental procedures available.
Low-energy fractures (also known as stress fractures) of the proximal femoral shaft may occur in patients receiving long-term alendronate. Fractures may occur after minimal trauma, or in its absence, some patients may experience pain in the hip, often with the outward signs of stress fracture for several weeks / months to vozniknoveniyapolnogo fracture of the femur.
Low-energy fractures of the proximal femoral shaft were often bilateral, therefore patients with long-existing fracture of the femoral shaft receiving bisphosphonates, should conduct a survey of the opposite thigh. Discontinuation of bisphosphonate therapy in patients with stress fracture is advantageously carried out after an assessment of their condition on the basis of an individual assessment of risk / benefit ratio.
The decision to conduct the treatment must be taken for each trenbolone patient individually after careful assessment of risk / benefit ratio, especially for patients with Barrett’s esophagus.
Research, dedicated alendronate effect on the ability to drive and use machines is not carried out.
However, since in patients receiving alendronate may develop dizziness, as well as other side effects, caution should be exercised when driving and operating machinery, and refrain from carrying out these activities in the case of side effects.
Special precautions for the destruction of unused medication
No need for special precautions during the destruction of the unused product.