Alendro-D S.P.M medicine for osteoporosis treatment and prevention (1 blister x 4 tablets)
Dosage form Box of 1 blister x 4 tablets
Specifications Cholecalciferol, alendronic acid
Ingredient The company tried to S.P.M part
Ingredient
Thành phần cho 1 viên
| Composition information | Content |
| Cholecalciferol | 5600iu |
| Alendronic Acid | 70mg |
Uses
indications
Alendro-D drug indicated treatment in the following cases:
is a synthetic aminobisphonate, a homogeneous substance of pyrophosphate, which has a specific effect on bone consumption. Different from pyrophosphate but similar to ETC Dronat and Pamidronat. Alendronat is not hydrolyzed by phosphatase phosphatase. Pre -clinical studies show that Alendronat accumulates selectively at the active bone pepper position, where Alendronat inhibits the operation of cell cancel. Alendronat attaches to the bone and has half -life eliminated lasting up to over 10 years. However, Alendronat still has pharmacological activity when attached to the skeleton.
Clinical studies show that Alendronat treatment can significantly increase the volume of bone in the spine, femur and transferred samples. In clinical studies in menopausal women from 40 to 85 years old with osteoporosis (determined to have low bone mass, at least two standard deviations below the average of the before menopause), Alendronate treatment significantly reduces the number of spine fractures after 3 years of medication. However, after 1-2 years of treatment, if the alend onat stops, it does not maintain an increase in bone mass. This proves to be constantly treated daily to maintain the healing effect.
colecalciferol:
As a secondosterol, the natural precursor of calcitriol hormone has a regulating calcium concentration in serum (1.25 dihydroxyvitamin d3), along with parathyroid hormones (PTH).
Colecalciferol increases the absorption of calcium in the gastrointestinal tract, reduces the concentration of pthucoma increases blood weight and alkaline phosphatase in serum, adjusting bone disorders due to kidney, muscle weakness and bone pain in people with chronic kidney failure.
calcifediol increases the absorption of calcium in the gastrointestinal tract and increases the concentration of calcium in the serum, reduces alkaline phosphatase levels in serum and pTH concentration in the blood, reduces bones under the bone membrane, the histological signs of bone disease due to hyperthyroidism and defects in minerals.
Calcifediol and calciTriol improves muscle muscle disease better than bone puree in adults suffering from kidney dysplasia.
doxercalciferol, unlike ergocalciferol, does not require hydrogen; YL has been active in the kidneys, so it can reduce PTH levels in serum or plasma people with chronic kidney failure.
pareecitol also reduces PTH levels in serum or plasma in people with chronic renal failure. Paricalcitol is as effective as Calcitriol to inhibit PTH; However, Paricalcitol has little effect on calcium and phosphor concentrations in serum because it is possible that Paricalcitol can only increase less calcium and phosphorus absorption in the intestine.
Dynamic pharmacokinetics
Alendronic Acid
absorption:
Alendronic Acid is absorbed by oral, absorbing drugs reduced by food, because products containing calcium or polymerization cations.
Alendronic acid's oral bioavailability is 0.4% if drinking 3 minutes before eating and almost negligible if drinking within 2 hours after eating.
Distribution:
Preparatory studies on male mice show that alendronic acid is temporarily distributed into soft tissues, when taking a dose of 1mg/kg body weight by intravenously, then the drug quickly reproduces into the bone or eliminated through urine. The integral distribution of at least 28 liters except in the bone, the concentration of the drug in serum is very low if used oral (less than 5 nanogam/ml), the ratio of cohesion to plasma protein is about 78%.
Metabolism:
Alendronat is not metabolized.
Era:
About half of the absorbed drugs are eliminated through urine; The other half is retained in the bone for a long time.
colecalciferol
absorption:
Colecalciferol is well absorbed through the gastrointestinal tract if normal fat absorption, colecalciferol is absorbed from the small intestine. The surface is necessary for absorbing colecalciferol in the intestine. Because colecalciferol is soluble in lipids, it is concentrated in micro -microorganisms, and is absorbed in the lymphatic system. Approximately 80% of the orally used colecalciferol is absorbed by this mechanism. Currently, it is unclear whether old age can change the physiological physiology of colecalciferol in the digestive tract.
Normal concentration of 25-hydroxyvitamin d (metabolites of colecalciferol in the liver) in plasma ranges from 8-80 nanogam/ml. The concentration of less than 11 nanogam/ml is considered a deficiency of vitamin D in infants, breastfed and young children. Although the concentration is needed to maintain normal calcium metabolism and maintain the best bone mass in older children and middle -aged people who are unknown, but for the elderly may need to increase the amount of vitamin D put into the body to achieve the above goal.
Distribution:
After absorption, Colecalciferol into the bloodstream through the microorganism of the white vein and then combine mainly with a special alpha-globulin (Vitamin D protein).
The metabolic substances (hydroxylation) of colecalciferol also circulating in the blood combined with Alpha-globulin. 25-Hydroxylergocalciferol and 25-Hydroxycoleciferolol are stored in fat and muscle for a long time. When vitamin D is completely released from the body through the chest or from the skin, Vitamin D will store in the liver for a few hours. 25-Hydroxyergocalciferol can be distributed into milk after high doses of Colecalciferol.
Metabolism:
colecalciferol is hydroxylation in the liver forming 25 - H /dropxolecalciferol and 25 - hydroxyergocalciferol respectively. These substances continue to be hydroxylation in the kidneys to form metabolites 1.25 - dihydroxycolecccerol and derivatives 1.24.25 - trihydroxy.
The liver is the place where vitamin D is converted into 25 - OHD, this substance is associated with protein and converts in the blood. In fact, 25 - OHD has high affinity with protein than the mother compound. The derivative 25 - Hydroxy has half a lifetime of 19 days and is the main form of vitamin D in the blood. The concentration in the stable state of 25 - OHD is 15 - 50 nanogam/ml. The half -life of Calcitriol is about 3-5 days, and 40% of the treatment dose is eliminated within 10 days. CalcitiIOL is hydroxylated by enamel hydroxylase in the kidney to 1,24.25 - (OH) 3DS, this enamel also hydroxylation 25 - OHD, to form 24.25 - (OH), d. Both compounds 24 - these hydroxy are less active than Calcitriol and possibly an excreted product
Era:
In the liver, Colecalciferol is hydroxylation in the mitochondria into 2t-hydroxycolecalciferol (Calcifediol) corresponding. These compounds are hydroxylation in the kidneys thanks to the vitamin D-1-hydroxylase enzyme to form the metabolic metabolic of 1.25- Jihydroxycoleciferol (Calcitriol) respectively. Half of the life of 25-hydroxy metabolites in the blood from 10 days to 3 weeks and half-life of metabolites 1.25-hydroxy about 4-6 hours.
Continue to transform more in the kidneys to form the derivatives of 1,24,25-troxy.
Before taking Alendro-D S.P.M medicine for osteoporosis treatment and prevention (1 blister x 4 tablets)
How to use
must take Alendronic acid at least 30 minutes before eating, or first medication of the day with normal water. Other drinks (including water), food and some drugs can reduce the absorption of alendronic acid.
To quickly put the drug into the stomach, in order to reduce irritation, reduce the side effects and in the esophagus, the patient should:
Dosage
Take 1 tablet of 70 mg of Alendronic acid, only once a week (7 days).
No need to adjust for the elderly or mild to moderate kidney failure (creatinine purification from 35 - 60 ml/minute). It is not recommended to use alendronic acid for people with worse renal impairment (creatinine clearance ratio
In case the patient forgets a dose of Alendronic acid used once a week, take a tablet in the next morning, right after discovering. Do not take two capsules at the same time but continue to take one capsules per week on the original selected day.
dose adjustment:
Alendronic Acid
No need to adjust the dose for the elderly or patients with mild to moderate kidney failure (creatinine purification from 35 to 60 ml/minute). It is not recommended to use alendronic acid for people with more severe renal impairment (creatinine clearance ratio
Vitamin D
Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.What to do when overdose? Overdose can cause blood calcium loss, hypoclapiasia, adverse effects in the gastrointestinal tract such as digestive disorders, heartburn, esophagitis, inflammation or stomach ulcers.
colecalciferol and vitamin D conductors: The manifestation of the symptom of vitamin D overdose is the strength of vitamin D and serum calcium toxic due to vitamin D as in the ADR.
In an emergency, call the 115 emergency center immediately or go to the nearest local health station.
What to do when you forget 1 dose? However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double dose to compensate for missed dose.
Side Effects
When using Alendro-D drugs often experience unwanted effects (ADR) such as:
Common
When treating high or prolonged doses, increasing blood calcium and blood phosphorus.
Symptoms: Anorexia, headache, nausea, vomiting, abdominal pain, constipation.
Symptoms: Calciumization of soft tissue, calcification, sensory neurological disorders.
Warnings
Before using the drug you need to read the instructions carefully and refer to the information below.
contraindicated
Alendro-D drugs contraindicated in the following cases:
Alendronic Acid:
Vitamin D3:
Be cautious when using
Alendronic Acid:
Like other bisphosphonates, Alendronic Acid can cause irritation at the above gastrointestinal mucosa.
There have been reports on harmful effects in the esophagus, such as esophagitis, esophageal ulcer and esophagus (manifesting such as difficulty swallowing, swallowing pain, post -sternum pain, heartburn) when leading to stenosis or perforation of the esophagus in patients treated with Alendronic Acid.
The risk of serious harmful reactions to the esophagus is greater in the patient who drinks alendronic acid improperly or continues to use alendronic acid after the symptoms are suspected of irritating the esophagus.
Although there is no increased risk in expanding lighting tests, there have been some reports on stomach and duodenum ulcers in some severe cases with complications. However, the cause of cause and effect has not been identified.
Be careful when using Alendronic Acid for patients with a history of gastrointestinal disease, such as difficulty swallowing, esophagus, inflammation or stomach ulcers, duodenum not recommended to use alendronic acid for patients with creatinine clearance
It is necessary to consider the causes of osteoporosis other than the deficiency of estrogen and aging.
Must adjust the condition of reducing blood calcium before starting with Alendronic Acid.
Metabolic disorders of other substances (such as vitamin D deficiency) also need to be actively treated.
used in alendronic acid pediatric acid has not been studied in children so it is not used for these cases.
used in aging: In clinical studies show that the effect and safety of alendronic acid is not related to age.
colecalciferol:
Be careful when taking vitamin D for patients with kidney function, the disease is body; atherosclerosis.
Vitamin D3 can increase increased calcium and/or increase calcium-increasing calcium when using people with diseases associated with overcurrent increase in calcitriol without air conditioning: leukemia, lymphoma, sarcoid disease). For people who need to monitor calcium levels in urine and serum.
The effect of the drug on the ability to drive and operate machinery
Because the drug causes headaches, auditory virtual, visual disorders, so it should not be used for drivers and machinery operation.
Use drugs for women during pregnancy and nursing mothers
Pregnant women:
Hypercalcemia during pregnancy, which can cause deformities (aortic stenosis, retinopathy, mental and physical growth) and hypothyroidism for the fetus to recommend vitamin D as 600 UI/day, so do not use this preparation for pregnant women.
Women who are breastfeeding:
Vitamin D secretes breast milk, vitamin D levels in breast milk are correlated with vitamin D concentration in the serum of the breast -feeding babies completely. So do not use this product for breastfeeding women.
Drug interaction
Alendronic Acid:
If taken at the same time, CalCl supplements, antacids (Antacla) and other oral medications will affect the absorption of alendronic acid. Therefore, patients need to carry T for half an hour after taking Alendronic Acid before starting other drugs.
There is no other clinical drug interaction, after using hormone replacement therapy (estrogen = progestin) along with alendronic acid on bone women after menstruation.
Using combination of Alendronic Acid and hormone replacement therapy is higher than the amount of bone increases, and the penalty penalty of the bone decreases more than the treatment for increasing each drug
colecalciferol:
Mineral oils, orlistates, bile acid recovery substances (for example Cholestyran in, Colestipol) can hinder the absorption of vitamin D. anti -convulsions, cimetidine, and thiazid gums that can increase vitamin D.
Do not simultaneously use vitamin D with phenobarbital and/or phenitoln (and maybe and other drugs that cause liver enzymes) because these drugs can reduce concentration 25 - hydroxyergocalciferol and 25 - hydroxy - colecalciferol in plasma and increase vitamin D transformation into non -active substances.
Do not simultaneously use vitamin D with corticosteroids because corticosteroids hinder the effect of vitamin D.
Do not simultaneously use vitamin D with cardiac glycosides because of the toxicity of glycosides aids increased by hypertension, leading to arrhythmia.
Storage
The cool, dry place.
To avoid sunlight and too high temperature.
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