Comparative Pharmacology
Head-to-head clinical analysis: ACTONEL versus FOSAMAX PLUS D.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ACTONEL versus FOSAMAX PLUS D.
ACTONEL vs FOSAMAX PLUS D
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Bisphosphonate that inhibits osteoclast-mediated bone resorption by binding to hydroxyapatite in bone and interfering with osteoclast activity.
Alendronate, a bisphosphonate, inhibits osteoclast-mediated bone resorption by binding to hydroxyapatite and interfering with the mevalonate pathway, leading to osteoclast apoptosis. Cholecalciferol (vitamin D3) promotes intestinal calcium absorption and bone mineralization.
35 mg orally once weekly or 5 mg orally once daily for osteoporosis; also 30 mg orally once weekly for Paget disease.
One tablet (alendronate 70 mg / cholecalciferol 2800 IU) orally once weekly.
None Documented
None Documented
Terminal elimination half-life: 1.5-2 hours (short for bisphosphonates due to rapid renal clearance); however, bone retention half-life is prolonged (>1 year) due to binding to hydroxyapatite.
Alendronate: Terminal half-life in bone is estimated at 10+ years due to slow release from the skeleton. Cholecalciferol: Half-life of 25-hydroxyvitamin D is ~15 days.
Renal: 50-60% unchanged via glomerular filtration and active tubular secretion; Fecal: minor, biliary excretion negligible.
Alendronate: ~50% excreted unchanged in urine; remainder is taken up by bone and slowly eliminated. No biliary or fecal excretion of intact drug. Cholecalciferol: ~50% excreted in bile via feces; less than 1% in urine.
Category C
Category C
Bisphosphonate
Bisphosphonate