Actonel with Calcium (Risedronate Sodium with Calcium Carbonate) Drug Information: Overdosage and Contraindications

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May 22, 2012

Actonel with Calcium

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Osteoporosis facts

Osteoporosis is a condition of increased susceptibility to fracture due to fragile bone.
Osteoporosis weakens bone and increases risk of bone fracture.
Bone mass (bone density) decreases after 35 years of age and decreases more rapidly in women after menopause.
Key risk factors for osteoporosis include genetics, lack of exercise, lack of calcium and vitamin D, personal history of fracture as an adult, cigarette smoking, excessive alcohol consumption, history of rheumatoid arthritis, low body weight, and family history of osteoporosis.
Patients with osteoporosis have no symptoms until bone fractures occur.
The diagnosis of osteoporosis can be suggested by X-rays and confirmed by tests to measure bone density.
Treatments for osteoporosis, in addition to prescription osteoporosis medications, include stopping use of alcohol and cigarettes, and assur...

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OVERDOSE

Actonel

Decreases in serum calcium and phosphorus following substantial overdose may be expected in some patients. Signs and symptoms of hypocalcemia may also occur in some of these patients. Milk or antacids containing calcium should be given to bind Actonel and reduce absorption of the drug.

In cases of substantial overdose, gastric lavage may be considered to remove unabsorbed drug. Standard procedures that are effective for treating hypocalcemia, including the administration of calcium intravenously, would be expected to restore physiologic amounts of ionized calcium and to relieve signs and symptoms of hypocalcemia.

Lethality after single oral doses was seen in female rats at 903 mg/kg and male rats at 1703 mg/kg. The minimum lethal dose in mice and rabbits was 4000 mg/kg and 1000 mg/kg. These values represent > 1000 times the 35 mg/week human dose based on surface area (mg/m²).

Calcium

Because of its limited intestinal absorption, overdosage with calcium carbonate is unlikely. However, prolonged use of very high doses can lead to hypercalcemia. Clinical manifestations of hypercalcemia may include anorexia, thirst, nausea, vomiting, constipation, abdominal pain, muscle weakness, fatigue, mental disturbances, polydipsia, polyuria, bone pain, nephrocalcinosis, renal calculi and in severe cases, cardiac arrhythmias.

Treatment: Calcium should be discontinued. Other therapies that may be contributing to the condition, such as thiazide diuretics, lithium, vitamin A, vitamin D and cardiac glycosides should also be discontinued. Gastric emptying of any residual calcium should be considered. Rehydration, and, according to severity, isolated or combined treatment with loop diuretics, bisphosphonates, calcitonin and corticosteroids should also be considered. Serum electrolytes, renal function and vital signs must be monitored.

CONTRAINDICATIONS

Actonel

Hypocalcemia (see PRECAUTIONS, General)
Known hypersensitivity to any component of this product
Inability to stand or sit upright for at least 30 minutes

Calcium

Hypercalcemia from any cause including, but not limited to, hyperparathyroidism, hypercalcemia of malignancy, or sarcoidosis.
Known hypersensitivity to any component of the product.

Last reviewed on RxList: 3/18/2011
This monograph has been modified to include the generic and brand name in many instances.