What is Actonel with Calcium (Calcium Carbonate Risedronate)?

Risedronate is in the group of medicines called bisphosphonates (bis FOS fo nayts). It alters the cycle of bone formation and breakdown in the body. Risedronate slows bone loss while increasing bone mass, which may prevent bone fractures.

Calcium is a mineral that is needed for many functions of the body, especially bone formation and maintenance.

Risedronate is used to treat or prevent postmenopausal and steroid-induced osteoporosis. Risedronate is also used to treat Paget’s disease of bone.

Calcium carbonate is used to prevent and to treat calcium deficiencies.

Calcium carbonate and risedronate may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about Actonel with Calcium (Calcium Carbonate Risedronate)?

Actonel with Calcium is packaged as two separate medicines: 4 risedronate tablets and 24 calcium tablets. Take a risedronate tablet one day per week, first thing in the morning, at least 30 minutes before you eat or drink anything or take any other medicine. Take a calcium tablet with food every day for the 6 days in between your risedronate doses. Only the calcium tablet should be taken with food. Risedronate must be taken on an empty stomach.
Do not take a risedronate tablet if you cannot sit upright or stand for at least 30 minutes. Risedronate can cause serious problems in the stomach or esophagus (the tube that connects your mouth and stomach). You will need to stay upright for at least 30 minutes after taking this medication.
Take each dose with a full glass (6 to 8 ounces) of water. Use only plain water (not mineral water) when taking a risedronate tablet.
For at least the first 30 minutes after taking a risedronate tablet, do not lie down or recline, do not eat or drink anything other than plain water, and do not take any other medicines including vitamins, calcium, or antacids.
Some people using medicines similar to risedronate have developed bone loss in the jaw, also called osteonecrosis of the jaw. Symptoms of this condition may include jaw pain, swelling, numbness, loose teeth, gum infection, or slow healing after injury or surgery involving the gums. You may be more likely to develop osteonecrosis of the jaw if you have cancer or have been treated with chemotherapy, radiation, or steroids. Other conditions associated with osteonecrosis of the jaw include blood clotting disorders, anemia (low red blood cells), and a pre-existing dental problem.
Calcium carbonate and risedronate is only part of a complete program of treatment that may also include diet changes, exercise, and taking vitamin supplements. Follow your diet, medication, and exercise routines very closely.
Take only the amount of calcium that your doctor recommends. Do not use other calcium supplements unless your doctor has told you to.

What should I discuss with my healthcare provider before taking Actonel with Calcium (Calcium Carbonate Risedronate)?

Do not take a risedronate tablet if you cannot sit upright or stand for at least 30 minutes. Risedronate can cause serious problems in the stomach or esophagus (the tube that connects your mouth and stomach). You will need to stay upright for at least 30 minutes after taking this medication.

If you have any of these other conditions, you may need a dose adjustment or special tests to safely use this medication:

low or high levels of calcium in your blood
kidney disease
trouble swallowing; or
an ulcer in your stomach or esophagus

Some people using medicines similar to risedronate have developed bone loss in the jaw, also called osteonecrosis of the jaw. Symptoms of this condition may include jaw pain, swelling, numbness, loose teeth, gum infection, or slow healing after injury or surgery involving the gums.

You may be more likely to develop osteonecrosis of the jaw if you have cancer or have been treated with chemotherapy, radiation, or steroids. Other conditions associated with osteonecrosis of the jaw include blood clotting disorders, anemia (low red blood cells), and dental surgery or pre-existing dental problems.

FDA pregnancy category C. It is not known whether calcium carbonate and risedronate is harmful to an unborn baby. Before taking this medication, tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether this medication passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Actonel with Calcium Side Effects

What are the possible side effects of Actonel with Calcium (Calcium Carbonate Risedronate)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using calcium carbonate and risedronate and call your doctor at once if you have any of these serious side effects:

chest pain
difficulty or pain when swallowing
pain or burning under the ribs or in the back
new or worsening heartburn
severe joint, bone, or muscle pain; or
jaw pain, numbness, or swelling

Less serious side effects may include:

mild heartburn, nausea, or stomach upset
diarrhea, gas, or constipation
muscle, joint, or back pain
pain or burning with urination
mild skin rash; or
headache or depressed mood

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. You may report side effects to FDA at 1-800-FDA-1088.

Actonel with Calcium Interactions

What other drugs affect Actonel with Calcium (Calcium Carbonate Risedronate)?

Antacids, supplements, or medicines that contain aluminum, calcium, magnesium, or other minerals can interfere with how your body absorbs risedronate. If you use these other medicines, do not that take them for at least 30 minutes after taking a risedronate tablet.

Before using calcium carbonate and risedronate, tell your doctor if you use any of the following drugs:

levothyroxine (Synthroid)
diuretics (water pills)
steroids (prednisone and others)
an antibiotic such as ciprofloxacin (Cipro), doxycycline (Doryx, Vibramycin), gatifloxacin (Tequin), levofloxacin (Levaquin), minocycline (Minocin), moxifloxacin (Avelox), ofloxacin (Floxin), sparfloxacin (Zagam), tetracycline (Sumycin, Achromycin, Robitet), and others; or
aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as celecoxib (Celebrex), diclofenac (Voltaren), diflunisal (Dolobid), ibuprofen (Motrin, Advil), indomethacin, ketoprofen (Orudis), ketorolac (Toradol), naproxen (Aleve, Naprosyn), piroxicam (Feldene), and others

There may be other drugs that can affect calcium carbonate and risedronate. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

What should I avoid while taking Actonel with Calcium (Calcium Carbonate Risedronate)?

Do not take any other medicines including vitamins, calcium, or antacids for at least 30 minutes after taking a risedronate tablet.

Do not lie down for at least 30 minutes after you take a risedronate tablet.

Do not take an iron supplement at the same time you take a calcium tablet. Take these minerals at separate times of the day.

Actonel with Calcium Dosage

How should I take Actonel with Calcium (Calcium Carbonate Risedronate)?

Take calcium carbonate and risedronate exactly as it was prescribed for you. Do not use the medication in larger amounts or for longer than recommended by your doctor.

Only the calcium tablet should be taken with food. Risedronate must be taken on an empty stomach.

Take the risedronate tablet first thing in the morning, at least 30 minutes before you eat or drink anything or take any other medicine. Take the risedronate tablet on the same day each week and always first thing in the morning.

Take the risedronate tablet with a full glass (6 to 8 ounces) of water. Use only plain water (not mineral water) when taking a risedronate tablet.

Do not crush, chew, or suck the risedronate tablet. Swallow the pill whole.

After taking a risedronate tablet, carefully follow these instructions:

Do not lie down or recline for at least 30 minutes
Do not eat or drink anything other than plain water
Do not take any other medicines including vitamins, calcium, or antacids for at least 30 minutes. It may be best to take your other medicines at a different time of the day. Talk with your doctor about the best dosing schedule for your other medicines

To be sure this medication is helping your condition, your bone mineral density will need to be tested on a regular basis. Do not miss any scheduled visits to your doctor.

Calcium carbonate and risedronate is only part of a complete program of treatment that may also include diet changes, exercise, and taking vitamin supplements. Follow your diet, medication, and exercise routines very closely.

Take only the amount of calcium that your doctor recommends. Do not use other calcium supplements unless your doctor has told you to.

Store calcium carbonate and risedronate tablets at room temperature away from moisture and heat.

What happens if I overdose on Actonel with Calcium (Calcium Carbonate Risedronate)?

Seek emergency medical attention if you think you have used too much risedronate. Drink a full glass of milk and call your local poison control center or emergency room right away. Do not make yourself vomit and do not lie down.

Overdose symptoms may include nausea, heartburn, stomach pain, diarrhea, muscle cramps, numbness or tingling, tight muscles in your face, seizure (convulsions), irritability, and unusual thoughts or behavior.

What happens if I miss a dose of Actonel with Calcium (Calcium Carbonate Risedronate)?

If you forget to take a risedronate tablet: If you forget to take this medicine first thing in the morning, do not take it later in the day. Wait until the following morning to take the medicine and skip the missed dose. Do not take two (2) tablets in one day.

If you forget to take a calcium carbonate tablet: Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

Edited from everydayhealth.com

Actonel with Calcium (Calcium Carbonate Risedronate)