Comparative Pharmacology
Head-to-head clinical analysis: ACTONEL WITH CALCIUM COPACKAGED versus ATELVIA.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ACTONEL WITH CALCIUM COPACKAGED versus ATELVIA.
ACTONEL WITH CALCIUM (COPACKAGED) vs ATELVIA
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
ACTONEL WITH CALCIUM (COPACKAGED) contains risedronate sodium, a bisphosphonate that inhibits osteoclast-mediated bone resorption by binding to hydroxyapatite crystals in bone and inhibiting farnesyl pyrophosphate synthase (FPPS), an enzyme in the mevalonate pathway. This leads to reduced bone turnover and increased bone mineral density. The calcium component is for supplementation to prevent hypocalcemia.
Risedronate (the active ingredient in ATELVIA) inhibits osteoclast-mediated bone resorption by binding to hydroxyapatite in bone and inhibiting the mevalonate pathway, which prevents farnesyl pyrophosphate synthase activity, leading to disruption of osteoclast function and induction of apoptosis.
Actonel (risedronate) 35 mg orally once weekly, taken with 6-8 oz of plain water at least 30 minutes before breakfast. Calcium supplement (e.g., 1250 mg calcium carbonate) taken with food at a different time of day.
35 mg orally once weekly on the same day each week, taken with at least 240 mL of plain water at least 30 minutes before the first food, beverage, or medication of the day. Do not crush, chew, or suck tablets.
None Documented
None Documented
Terminal elimination half-life of risedronate is approximately 20 hours for the 5 mg daily dose and 480 hours for the 35 mg weekly dose due to prolonged retention in bone; clinically, the drug accumulates in bone and is slowly released.
Terminal elimination half-life is approximately 10 days due to prolonged bone binding and slow release; clinical suppression of bone resorption persists for weeks after discontinuation.
Risedronate is eliminated primarily via renal excretion, with approximately 50% of an absorbed dose excreted unchanged in urine. Unabsorbed drug is eliminated in feces. Total clearance is about 100 mL/min.
Approximately 50% of absorbed dose excreted renally unchanged; remainder eliminated via biliary/fecal routes. Renal clearance correlates with creatinine clearance.
Category C
Category C
Bisphosphonate and Calcium Supplement
Bisphosphonate