BMA Concise Guide to Medicine & Drugs


Brand names Actonel, Actonel Once a Week

Used in the following combined preparation Actonel Combi


Drug group Drug for bone disorders

Overdose danger rating Medium

Dependence rating Low

Prescription needed Yes

Available as generic No


Risedronate belongs to a group of drugs called bisphosphonates. Used in the treatment of bone disorders such as Paget’s disease, the drug works directly on the bones by increasing the amount of calcium they absorb, thereby making them stronger.

Risedronate is also used in the prevention and treatment of osteoporosis in postmenopausal women. Taken as either a daily or a weekly dose, it reduces the risk of fractures of the hip or vertebrae. The drug is also used to treat or prevent steroid-induced osteoporosis.

To reduce the risk of gastrointestinal adverse effects, you should take risedronate first thing in the morning, on an empty stomach and in a standing position, and remain upright for at least 30 minutes afterwards. Risedronate should not be taken at bedtime.


Your drug prescription is tailored for you. Do not alter dosage without checking with your doctor.

How taken/used Tablets.

Frequency and timing of doses Paget’s disease Once daily (30mg dose). Osteoporosis Once daily (5mg dose); once weekly, on the same day (35mg dose). Swallow whole with water, on rising and before food; or avoid food or drink for at least two hours before and after dose.

Adult dosage range Paget’s disease 30mg daily. Osteoporosis 5mg daily; 35mg weekly.

Onset of effect Within 1 month.

Duration of action Some effects may persist for several weeks or months.

Diet advice Avoid calcium-containing products (e.g. milk), vitamin and mineral supplements, and antacids for at least two hours before and after dose.

Storage Keep in original container at room temperature out of the reach of children.

Missed dose Take as soon as you remember. Then return to your original dosing schedule. Do not make up for the missed dose (weekly).

Stopping the drug The drug can be safely stopped as soon as you no longer need it.

Exceeding the dose An occasional unintentional dose is unlikely to cause problems. However, if you notice any unusual symptoms, or if a large overdose has been taken, drink a large glass of milk and notify your doctor.


Most adverse effects of risedronate are mild to moderate and do not usually necessitate stopping treatment. Common side effects include nausea, diarrhoea or constipation, muscle pain, headache, abdominal pain, and new or worsening heartburn. Notify your doctor if you experience abdominal pain, if heartburn develops or worsens, if any of the other common symptoms are severe, or if you develop jaw pain. If swallowing is difficult or painful or if jaundice occurs, stop taking the drug and contact your doctor. If you develop an allergic rash, itching, or facial swelling, stop taking the drug and seek immediate medical attention.


Antacids, and products containing calcium or iron These reduce the absorption of risedronate and should be taken at a different time of day.


Be sure to tell your doctor if:

· You have kidney problems.

· You have a history of peptic ulcers or stomach problems.

· You have low calcium levels in your blood.

· You are/may be pregnant or are planning pregnancy.

· You are breast-feeding.

· You are unable to sit or stand upright for at least 30 minutes.

· You have had pain or difficulty in swallowing, or problems with your oesophagus.

· You are taking other medicines.

Pregnancy Not recommended.

Breast-feeding Not recommended.

Infants and children Not recommended.

Over 60 No special problems.

Driving and hazardous work No special problems.

Alcohol Avoid. May cause further stomach irritation.


In patients with Paget’s disease, courses of treatment longer than two months are not usually prescribed but repeat courses may be required. When used to treat or prevent osteoporosis, risedronate may be taken safely long-term.

Monitoring Your doctor may monitor your bone mineral density. Blood and urine tests may be carried out at intervals.