Tevabon® (Tevabon®)

For the use of alendronic acid

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 the appearance or intensification of heartburn.

In connection with the existing risk of irritation of the mucous membrane of the upper gastrointestinal tract, as well as aggravation of the course of the underlying disease, it is recommended take care when administration of the drug to patients with gastrointestinal diseases in the exacerbation phase, such as dysphagia, esophagitis, gastritis, duodenitis, peptic ulcer and duodenal ulcers, as well as recent gastrointestinal diseases (peptic ulcer and duodenal ulcer, active bleeding from the digestive tract, surgical intervention on the upper gastrointestinal tract, except for pyloroplasty) during the previous year. There are reports of cases of osteonecrosis of the jaw, usually related to tooth extraction and / or local infection (including osteomyelitis), in patients with oncological diseases receiving treatment regimens, including BF (primarily, intravenous). Many of these patients also received chemotherapy and GCS. There are also reports of osteonecrosis of the jaw in patients with osteoporosis who receive oral BF. Before application of BF to patients with Concomitant risk factors (eg, cancer, chemotherapy, radiation therapy, GCS therapy, poor oral hygiene) dental examination with appropriate preventive treatment of teeth. Patients in the treatment of BF should avoid invasive dental procedures whenever possible. In patients with osteonecrosis of the jaw, who are on therapy with BF, dental surgical interventions can lead to deterioration. If necessary surgical interventions should be taken into account that data on the possibility of reducing the risk of osteonecrosis of the jaw after abolition of the BF are absent. The appointments and recommendations of the attending physician should be based on an individual assessment of the benefit / risk ratio for each patient. The time of pain in the bones, joints, and muscles in patients during BF therapy varied or 1 day to several months after the start of treatment. In most patients, after the cessation of treatment, there was a decrease in the severity of the pain, in some patients the pain reappeared with the resumption of therapy with the same or another BF.

If the patient forgot to take a tablet of alendronic acid, then it should be taken the next morning. Do not take two tablets in one day, you need to continue taking 1 tablet once a week on the day that was chosen for admission from the beginning of treatment.

In patients with hypocalcemia, hypovitaminosis D and hypoparathyroidism, it is necessary to carry out corrective therapy of mineral metabolism disorders before treatment with alendronic acid. As a result, positive impact alendronic acid on the mineral density of bone tissue during treatment can be observed insignificant asymptomatic reduction concentration of calcium and phosphorus in the blood serum. There are isolated reports of symptomatic hypocalcemia, sometimes severe, usually in patients with predisposition to it (eg, with hypoparathyroidism, vitamin deficiency D, malabsorption of calcium).

There are reports of occurrence of stress fractures of the proximal femur with prolonged treatment with alendronic acid (from 18 months to 10 years). Fractures occurred after minimal injury or without it. Some patients initially experienced pain in the proximal part of the thigh that persisted for several weeks or even months before the symptom ended with a fracture of the femur. Often fractures were bilateral, so if a fracture of one femur is needed, the patient needs monitor the status of another thigh bone.

In patients taking alendronic acid, especially with concomitant therapy with GCS, it is extremely important to ensure sufficient intake of calcium and vitamin D with food or in the form of medicines.

Absorption of BF is significantly reduced by simultaneous meals.

For the use of alfacalcidol

Alfacalcidol may increase hypercalcemia and / or hypercalciuria in its appointment to patients with a disease associated with uncontrolled hyperproduction of calcitriol (eg, in leukemia, lymphoma, sarcoidosis), and may also increase hyperphosphatemia. At a calcium concentration in the plasma of more than 2.6 mmol / l, it is necessary to exclude the use of other calcium-containing drugs. If there is no effect, cease taking capsules of alfacalcidol before the normalization of serum calcium concentration (2.2-2.6 mmol / l). Control Calcium and phosphate concentrations in the blood are carried out before treatment with alfacalcidol and necessary Corrective therapy. In the treatment of alfacalcidol the concentration of electrolytes at the beginning is determined once a week, when reaching Cmand during the entire treatment period - every 3-5 weeks, and also monitor the activity of alkaline phosphatase (with a violation of kidney function (KC more than 35 ml / min) - weekly monitoring).

Peanut butter in rare cases can cause severe allergic reactions.

Patients with hereditary intolerance to fructose or malabsorption of fructose should not be prescribed Tevabon ®, since the kit includes capsules of alfacalcidol containing sorbitol.