Osteoporosis

Actonel, Prilosec, Calcium Citrate

02/26/2000 09:59PM

Question:

1. What about taking Actonel if one has a diagnosis of gastritis? 2. Does Prilosec interfere with or change the efficacy of other meds, e.g. atenolol, Claritin, Premarin,glucosamine sulfate, or calcium citrate? 3. Should calcium citrate be taken with meals or on an empty stomach (same Dx of gastritis)?

Answer:

1. Actonel is a new third-generation cyclic aminobisphosphonate that was just approved by the FDA for the treatment of postmenopausal and glucocorticoid-induced osteoporosis. As with other aminobisphosphonates, Actonel can theoretically increase the risk of upper GI side effects although in the initial studies, it was well tolerated. You should discuss the appropriate use of this new medication in your specific situation with your physician who can better weigh the risks and benefits of a medication for you based on your specific health history.
2. Prilosec should not significantly decrease or change the efficacy of most of the medications you mention that are used in the treatment of osteoporosis. It does however, decrease the aborption of calcium carbonate, and thus, individuals who must take a proton-pump inhibitor, H2 blocker or other medication that reduces gastric acid secretion should use calcium citrate or lactate as a calcium supplement.
3.Calcium citrate may be taken on an empty stomach if desired. One should avoid taking most calcium sources directly with their meals as they may bind to phosphate and decrease absorption.

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Response by:

Rebecca D. Jackson, MD
Associate Professor, Internal Medicine
Endocrinology, Diabetes, & Metabolism
Department of Internal Medicine
College of Medicine
The Ohio State University