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Calcium* | |
|
Antacids Calcium Food Iron Magnesium Zinc (absorption) Zinc (action) | |
| Side effect reduction/prevention |
None known |
| Supportive interaction |
None known |
| Adverse interaction |
None known |
An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.
Calcium and Vitamin D
Short-term treatment with risedronate in people with hyperparathydoidism—a disorder
characterised by high blood levels of calcium—resulted in lower calcium blood
levels.1 Additional research is needed to determine whether people taking
risedronate for Paget’s disease might develop low blood calcium levels. As a precaution,
people with Paget’s disease should take supplemental calcium and vitamin D if dietary
intake is inadequate. However, taking risedronate at the same time as calcium supplements
reduces absorption of the drug.2 Therefore, people taking risedronate for
Paget’s disease should take calcium supplements an hour before or two hours after taking
the drug.
Minerals
Taking risedronate at the same time as iron, zinc, or magnesium may reduce the
amount of drug absorbed.3 Therefore, people taking risedronate who wish to
supplement with these minerals should take them an hour before or two hours after the
drug.
Antacids
Taking risedronate at the same time as antacids containing
calcium or magnesium may reduce absorption of the
drug. Therefore, people taking risedronate should take calcium- or magnesium-containing
antacids an hour before or two hours after the drug.
Food
One controlled study showed that taking risedronate either a half an hour before or two hours
after a meal dramatically reduced absorption of the drug, compared with taking the drug one
hour before or four hours after a meal.4 Consequently, people should take
risedronate one hour before a meal or 4 hours after a meal, as long as the latter is at least
one hour before the next meal.
1. Reasner CA, Stone MD, Hosking DJ, et al. Acute changes in calcium homeostasis during treatment of primary hyperparathyroidism with risedronate. J Clin Endocrinol Metab 1993;77:1067–71.
2. Sifton DW, ed. Physicians’ Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 2504–6.
3. Sifton DW, ed. Physicians’ Desk Reference. Montvale, NJ: Medical Economics Company, Inc. 2000, 2504–6.
4. Mitchell DY, Heise MA, Pallone KA, et al. The effect of dosing regimen on the pharmacokinetics of risedronate. Br J Clin Pharmacol 1999;48:536–42.
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