Special attention should be paid to any signs of the occurrence of adverse reactions in the esophagus. The patient should be informed of the need to stop taking the drug and contact a doctor when developing dysphagia, pain when swallowing, chest pain, or heartburn.
It is necessary to inform the patient about the possible risk of damage to the mucous membrane of the esophagus when not following the instructions for use.
In connection with the danger of irritation of the mucous membrane in the upper part of the gastrointestinal tract and the risk of aggravation of the underlying disease, it is recommended to take precautions when prescribing the drug to patients with gastrointestinal diseases such as dysphagia, esophageal diseases, gastritis, duodenal ulcer in the acute stage.
In patients with hypocalcemia before the start of treatment with alendronic acid, it is necessary to carry out corrective therapy for mineral metabolism disorders including hypovitaminosis D. In the process of treatment, there may be a slight asymptomatic decrease in calcium concentration in blood serum and phosphates due to the positive effect of alendronic acid on bone mineral density, which is of particular importance for patients undergoing glucocorticosteroid therapy, since they may have a decreased absorption of calcium.
When taking Strongos (especially with glucocorticosteroids) it is necessary to ensure adequate intake of calcium and vitamin D with food or in the form of medicines.
Absorption of bisphosphonates is significantly reduced by simultaneous intake of food.
When appointing other bisphosphonates, there was rarely osteonecrosis of the jaw. Most cases have been reported in cancer patients during dental procedures, several cases in patients with postmenopausal osteoporosis or other diseases. Risk factors for osteonecrosis of the jaw include establishing a diagnosis of cancer, concomitant therapies (chemotherapy, radiotherapy, corticosteroids) and other disorders (anemia, coagulopathy, infection, gum disease). Most cases were noted with the intravenous administration of bisphosphonates, but individual cases were observed in patients receiving drugs inward. Surgical dental intervention against the background of bisphosphonate therapy can enhance the manifestations of the osteonecrosis of the jaw. It is unknown whether the risk of osteonecrosis reduces the elimination of bisphosphonates. The decision to conduct treatment should be taken for each patient individually after assessing the risk / benefit ratio.