Comparative Pharmacology
Head-to-head clinical analysis: ACTONEL WITH CALCIUM COPACKAGED versus SKELID.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ACTONEL WITH CALCIUM COPACKAGED versus SKELID.
ACTONEL WITH CALCIUM (COPACKAGED) vs SKELID
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.
SKELID (tiludronate disodium) is a bisphosphonate that inhibits osteoclast-mediated bone resorption by binding to hydroxyapatite crystals in bone and inhibiting osteoclast activity and recruitment.
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.
400 mg (2 tablets) orally once daily, taken on an empty stomach at least 2 hours before or after food, for 2 hours with 8 oz plain water; avoid other beverages, food, and medications for 2 hours post-dose.
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: 10-12 hours (prolonged in renal impairment; no dose adjustment required for mild-moderate impairment but contraindicated in severe impairment [CrCl <30 mL/min])
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.
Renal: 50-60% unchanged drug; biliary/fecal: <5%
Category C
Category C
Bisphosphonate and Calcium Supplement
Bisphosphonate