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What’s the Best Way to Take Delayed Release Risedronate?

Delayed release risedronate for osteoporosis should be taken during breakfast or immediately afterwards to avoid digestive distress.
What’s the Best Way to Take Delayed Release Risedronate?
Male doctor and senior patient discussing scan results at the office. Doctor showing to senior woman x-ray in a medical clinic. Mature doctor showing a radiography to his patient.

We get excited when people ask about the best way to take their medicine. If you take certain medicines with food, you may not absorb them well. Other medicines get into your system better if you take them with food. But we don’t always think about this, and sometimes we get conflicting instructions. One reader was puzzled about delayed release risedronate, an osteoporosis medicine taken once a week.

Conflicting Instructions on Delayed Release Risedronate:

Q. I have osteoporosis and just picked up a new prescription of Risedronate Sodium Delayed Release Tablets. The label on the bottle has my doctor’s instructions to take the pill 30 minutes before my first food or drink. That’s the traditional method for the instant release risedronate I used to take.
The pharmacy included an instruction sheet telling me to take one tablet on the same morning each week immediately following breakfast. Please tell me which method is more effective, or if it makes a difference.

A. Your doctor may have confused the delayed-release with the immediate-release formulation. The official prescribing information for delayed release risedronate tablets advises taking the pills “immediately following breakfast.” If you take the drug before breakfast, on an empty stomach, you run a higher risk of a serious stomachache.

Be sure to swallow the tablet with a full glass of water to make sure it doesn’t get stuck. The ingredients can irritate the esophagus.

What Is Risedronate?

Risedronate (Actonel, Atelvia), like alendronate (Fosamax) and ibandronate (Boniva), slows bone breakdown. The body is constantly remodeling the bones, with some cells pulling bone cells apart and others building new bone. In osteoporosis, cells that destroy bone get way ahead of the bone-building cells. As a result, the bones lose density and become weak. 

Bisphosphonate drugs such as delayed release risedronate help get these processes back in balance. Consequently, bone density increases and people are less likely to break a vertebra or a hip (Clinical Therapeutics, Sep. 2007).

Some people prefer to take risedronate once a week, as you now are, instead of every day as you used to do. Studies suggest that both regimens work fairly well (Osteoporosis International, Jan. 2013).

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
  • Välimäki M et al, "Effects of risedronate 5 mg/d on bone mineral density and bone turnover markers in late-postmenopausal women with osteopenia: a multinational, 24-month, randomized, double-blind, placebo-controlled, parallel-group, phase III trial." Clinical Therapeutics, Sep. 2007. DOI: 10.1016/j.clinthera.2007.09.017
  • Soen S et al, "Phase II/III, randomized, double-blind, parallel-group study of monthly delayed-release versus daily immediate-release risedronate tablets in Japanese patients with involutional osteoporosis." Journal of Bone and Mineral Metabolism, Jan. 2020. DOI: 10.1007/s00774-019-01031-x
  • McClung MR et al, "Treatment of postmenopausal osteoporosis with delayed-release risedronate 35 mg weekly for 2 years." Osteoporosis International, Jan. 2013. DOI: 10.1007/s00198-012-2175-7
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