Comparative Pharmacology
Head-to-head clinical analysis: ACTONEL WITH CALCIUM COPACKAGED versus RECLAST.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ACTONEL WITH CALCIUM COPACKAGED versus RECLAST.
ACTONEL WITH CALCIUM (COPACKAGED) vs RECLAST
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.
Inhibits osteoclast-mediated bone resorption by binding to hydroxyapatite in bone and inhibiting farnesyl diphosphate synthase (FPPS), a key enzyme in the mevalonate pathway, leading to disruption of osteoclast activity 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.
5 mg intravenously over at least 15 minutes once yearly for osteoporosis.
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.
The terminal elimination half-life of zoledronic acid in plasma is approximately 146 hours (range 76-250 hours) due to slow release from bone. Clinically, this supports a once-yearly dosing interval for osteoporosis.
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.
Primarily renal; unchanged drug is excreted in urine. Approximately 50% of an absorbed dose is excreted unchanged in urine within 24 hours. The remainder is eliminated via renal excretion over an extended period, with negligible fecal or biliary elimination.
Category C
Category C
Bisphosphonate and Calcium Supplement
Bisphosphonate