Risedronate

What is risedronate?

Risedronate, known by brand names like Actonel or Actonel Once a Week, is a prescription medicine used to treat and prevent loss to bone density. It belongs to a group of medicines called bisphosphonates, which help strengthen bones and reduce the risk of fractures[1].  

What is risedronate used for?

Risedronate is prescribed for[1]: 

• Osteoporosis in men and postmenopausal women at risk of bone fractures 

• Osteoporosis caused by long-term steroid use 

• Paget’s disease of bone, a condition that disrupts normal bone renewal 

How does risedronate work?

Risedronate works by slowing down the activity of osteoclasts – cells that break down bone. This helps restore balance between bone loss and bone formation, resulting in stronger bones and fewer fractures[1].  

Who can take risedronate?

Most adults over 18 can take risedronate, and it may be prescribed to children in rare cases. You should speak to a doctor first if you[1]: 

• Have difficulty swallowing or problems with the oesophagus 

• Are unable to sit or stand upright for at least 30 minutes 

• Have low calcium levels (hypocalcaemia) 

• Have severe kidney problems 

• Have cancer, or are receiving radiotherapy or chemotherapy 

• Have teeth problems or are waiting for dental surgery 

• Smoke or used to smoke 

• Are pregnant, trying to get pregnant, or breastfeeding  

• Are allergic to risedronate 

Please tell your doctor or pharmacist about any conditions you may have or medication you take before you start treatment, and always follow the instructions in the Patient Information Leaflet[2].  

What is the typical dosage of risedronate?

Risedronate tablets come in strengths of 5mg, 30mg and 35mg. The dose depends on the condition being treated[1]: 

• Osteoporosis: 35mg once a week or 5mg daily 

• Paget’s disease: 30mg daily for two months 

How do you take risedronate?

To ensure effectiveness and reduce side effects, follow these instructions[1]: 

• Take first thing in the morning on an empty stomach 

• Swallow whole with at least 120ml (half a glass) of plain water 

• Remain upright (sitting or standing) for 30 minutes after taking 

• Do not eat, drink anything except water, or take any other medicines for at least 30 minutes  

Can you stop taking risedronate?

You can stop taking risedronate, but only under medical supervision. The effects of the medicine may continue for up to a year after stopping. Treatment is typically reviewed after 5 years[1].   

What do you do if you take too much risedronate?

Taking too much risedronate can lower calcium levels or upset your stomach. If this happens, do not lie down or try to vomit. Contact your GP, call NHS 111, or go to A&E immediately[1]. 

What do you do if you forget to take risedronate?

What to do depends on your schedule[1]: 

• Daily dose: Take it later the same day on an empty stomach. If not possible, skip it and take the next dose as usual. 

• Weekly dose: Take it the next morning after you remember. If close to your next dose, skip the missed one 

How do you store risedronate?

To maintain its effectiveness, store your medication properly. Please keep it in a cool, dry place away from direct heat or sunlight, and keep it out of the reach of children[1]. 

What medicines can’t you take with risedronate?

Avoid taking risedronate at the same time as the following[1]: 

• Antacids (e.g., Maalox, Mucogel, or Milk of Magnesia) 

• Calcium, magnesium, iron, or zinc supplements 

• Non-steroidal anti-inflammatory drugs (NSAIDs) 

• Steroids (e.g., prednisolone or dexamethasone) 

• Certain antibiotics (e.g., gentamicin, amikacin, streptomycin, or tobramycin) 

• Cancer treatments (e.g., bevacizumab or thalidomide) 

• Excess iron medicine (e.g., deferasirox) 

• Hypoparathyroidism treatment (e.g., parathyroid hormone) 

Wait at least 30 minutes after taking risedronate before using other medicines. Always inform your doctor or pharmacist about all medications and supplements you take before you start a new medicine, and follow the instructions in the Patient Information Leaflet[2]. 

What are the side effects of risedronate?

Like all medicines, risedronate can cause side effects. Common side effects include[1]: 

• Indigestion, bloating, or heartburn 

• Stomach pain 

• Headache 

• Constipation 

• Diarrhoea 

• Nausea 

• Muscle, joint, or back pain 

Rare but serious side effects include[1]: 

• Jaw problems (osteonecrosis) 

• Unusual thigh bone fractures 

• Severe irritation of the oesophagus 

• Severe joint pain 

• Black or red poo 

• Ear damage or pain 

• Blurred vision or light sensitivity 

• Muscle cramps or spasms 

• Ulcers in your food pipe 

You should contact your GP if you experience any of these symptoms. In rare cases, the medicine may cause a serious allergic reaction (anaphylaxis). You should call 999 or visit A&E immediately if you believe this is happening[1]. 

Symptoms of anaphylaxis include[1]:  

• Difficulty breathing  

• Tightness in throat and chest  

• Swelling of the tongue or throat  

• Feeling faint or dizzy  

• Blue/grey skin or lips  

• Loss of consciousness 

If you experience any side effects, including those not listed, you are encouraged to report them via the Yellow Card Scheme or contact your doctor, pharmacist, or nurse. This information is intended as a summary for general awareness and does not replace professional medical advice. 

The information provided in the side effects section is not a comprehensive list of all possible side effects associated with this medication. For a complete list of side effects, please refer to the Patient Information Leaflet (PIL) provided with your medication or consult your healthcare professional[2]. 

Frequently asked questions about risedronate

How long does risedronate take to work? 
It may begin working in 2 weeks, but full effects are usually seen after 6 months[1]. 

Can I drink coffee or juice with risedronate? 
No. Only plain water should be used when taking the tablet[1]. 

Can I take risedronate with food? 
No. It must be taken on an empty stomach to be effective[1]. 

Can I take supplements with risedronate? 
Yes but wait at least 30 minutes after taking risedronate[1]. 

Is risedronate safe for long-term use? 
Generally, yes, but treatment is reassessed after 3 to 5 years[1]. 

Can I take it risedronate if I have reflux? 
Possibly, but it should be discussed with your doctor[1]. 

What if I vomit after taking risedronate? 
Do not retake the dose. Contact your doctor for advice[1]. 

Can I take it during pregnancy? 
No. It is not recommended for use in pregnancy[1]. 

For the official NHS guide to risedronate, visit their website.