Comparative Pharmacology
Head-to-head clinical analysis: FOSAMAX versus FOSAMAX PLUS D.
Peer-Reviewed Evidence
Head-to-head clinical analysis: FOSAMAX versus FOSAMAX PLUS D.
FOSAMAX 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 matrix and impairing osteoclast activity through inhibition of farnesyl pyrophosphate synthase.
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.
70 mg orally once weekly for osteoporosis; 10 mg orally once daily for Paget's disease.
One tablet (alendronate 70 mg / cholecalciferol 2800 IU) orally once weekly.
None Documented
None Documented
Terminal elimination half-life is approximately 10.5 years in bone, reflecting slow release from the skeleton. Plasma half-life after intravenous administration is about 1 hour.
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 excretion of unchanged drug is the primary route (approximately 50% of absorbed dose). Unabsorbed drug is eliminated in feces. No biliary excretion.
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