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Package leaflet: Information for the patient

Alendronic Acid 70 mg Tablets

(sodium alendronate)

Read all of this leaflet carefully before you

start taking this medicine because it contains

important information for you.

•    Keep this leaflet. You may need to read it again.

•    If you have any further questions, ask your doctor or pharmacist.

•    This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.

•    If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.

What is in this leaflet:

1.    What Alendronic Acid is and what it is used for

2.    What you need to know before you take Alendronic Acid

3.    How to take Alendronic Acid

4.    Possible side effects

5.    How to store Alendronic Acid

6.    Contents of the pack and other information

1.    What Alendronic Acid is and what it is used for

Alendronic Acid contains the active substance sodium alendronate.

Your medicine is in the form of a tablet. Alendronic Acid belongs to a group of medicines called bisphosphonates. Bisphosphonates can be used to help bone disease such as osteoporosis. Alendronic Acid can treat and prevent osteoporosis in post-menopausal women, by stopping bones becoming thinner and weaker.

2.    What you need to know before you take Alendronic Acid

Do not take Alendronic Acid:

•    if you are allergic to sodium alendronate or any of the other ingredients of this medicine (listed in section 6)

•    if you have problems with your gullet (oesophagus - the tube that connects your mouth with your stomach) causing difficulty swallowing or food to become stuck

•    if you know you have very low blood levels of calcium (hypocalcaemia)

•    if you are unable to stand or sit upright for at least 30 minutes.

Warnings and precautions

Talk to your doctor or pharmacist before taking Alendronic Acid:

•    if you suffer from kidney problems

•    if you have any swallowing or digestive or gut problems

•    if in the last year you have had a stomach ulcer, bleed or surgery in the stomach, gullet or throat

•    if you have pain on swallowing

•    if you have been told you have low blood levels of calcium or you suffer from vitamin D deficiency or hypoparathyroidism (which can affect calcium levels). These need to be treated before you start taking Alendronic Acid

•    if your doctor has told you that you have Barrett's oesophagus (a condition associated with changes in the cells that line the lower oesophagus)

Irritation, inflammation or ulceration of the gullet often with symptoms of chest pain, heartburn, or difficulty or pain upon swallowing may occur, especially if the tablets are not taken with a full glass of water and/or if you lie down less than 30 minutes after taking the tablets. These side effects may worsen if you continue to take the tablets after developing these symptoms. See the 'How to take' instructions later on in this leaflet to see how you should take the tablets. If you have any questions, ask your doctor or pharmacist.

Dental and jaw problems

Alendronic Acid can cause damage (including death or loss) of bone in the jaw. This risk is increased:

•    if you have poor dental health, gum disease, poorly fitted dentures, a planned dental extraction or you do not receive routine dental care

•    if you have cancer

•    if you are undergoing chemotherapy or radiotherapy

•    if you are taking corticosteroids (such as prednisone or dexamethasone)

•    if you are or have been a smoker

Therefore you may be advised to have a dental check-up before starting treatment with Alendronic Acid.

It is important to maintain good oral hygiene when being treated with Alendronic Acid. You should have routine dental check-ups throughout your treatment and you should contact your doctor or dentist if you experience any problems with your mouth or teeth such as loose teeth, pain or swelling.

Children and adolescents:

Alendronic Acid should not be given to children and adolescents.

Other medicines and Alendronic Acid:

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines including medicines obtained without a prescription, or any of the following:

•    calcium supplements

•    antacids for indigestion

•    corticosteroid medicines, such as prednisolone or dexamethasone, used to reduce inflammation; as it is important that you have a good dietary intake of calcium and vitamin D (a risk factor for dental problems - see 'Dental and jaw problems')

•    certain medicines for rheumatism or longterm pain called NSAIDs (e.g. aspirin or ibuprofen) might cause digestive problems. Therefore, caution should be used when these medicines are taken at the same time as Alendronic Acid.

Wait at least 30 minutes after taking Alendronic Acid before taking any other medicines.

Alendronic Acid with food and drink:

If taken at the same time it is likely that food and drink (including mineral water) will interfere with the absorption of Alendronic Acid. Therefore you should take Alendronic Acid with plain water at least 30 minutes before any food or drink.

Pregnancy and breast-feeding:

Alendronic Acid is only intended for use in postmenopausal women. Do not take Alendronic Acid if you are pregnant, or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.

Driving and using machines:

There have been side effects (including blurred vision, dizziness and severe bone, muscle or joint pain) reported with alendronate that may affect your ability to drive or operate machinery. Do not drive or operate machinery until you are sure you are not affected.

Alendronic Acid contains lactose. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicine.

3. How to take Alendronic Acid

Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.

The recommended dose is one tablet once weekly.

Use in patients with kidney problems:

Alendronic Acid is not recommended for patients with severe kidney problems.

Method of administration

•    Take on an empty stomach, as soon as you get out of bed in the morning, before you eat or drink anything.

•    Swallow the tablet whole while standing upright. Take with a full glass (not less than 200 mls or 7 fl. oz.) of plain water (not mineral water).

*    Do not take with mineral water (still or sparkling).

*    Do not take with coffee or tea.

*    Do not take with juice or milk.

•    Do not crush or chew or let the tablet dissolve in your mouth.

•    Do not take at bedtime. You should not lie down after taking Alendronic Acid until you have had something to eat.

•    However, you must leave at least 30 minutes after swallowing the tablet before you eat, drink or take any other medicines.

Stop taking this medicine and tell your doctor if you notice:

•    soreness, pain and difficulty swallowing

•    pain in the centre of the chest

•    heartburn, either new or worse than usual

•    ulcers in your mouth and throat.

If you take more Alendronic Acid than you should:

Drink a full glass of milk and contact your doctor or nearest hospital casualty department immediately. Take any remaining tablets and the container with you. Do not make yourself vomit, and do not lie down. In case of an overdose, you may experience an upset stomach, heartburn, stomach pain, nausea, vomiting, vomiting blood, blood in the bowel motions.

If you forget to take Alendronic Acid:

Take the tablet on the morning after you remember. Do not take two tablets on the same day and return to taking one tablet once a week, on the day instructed by your doctor.

If you stop taking Alendronic Acid:

Always talk to your doctor or pharmacist before stopping taking Alendronic Acid.

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Stop taking this medicine and tell your doctor immediately if you experience any of the following symptoms:

Common (may affect up to 1 in 10 people):

•    pain in the mouth, throat, chest or stomach which may be associated with eating. You may feel bloated, sick or be sick, have a loss of appetite or have a loss of weight. These may be signs of inflammation or ulceration in the digestive tract. If you are sick, you may also notice paricles that looks like coffee grounds or you may pass black, tar-like stools

•    new or worsening heartburn or indigestion, pain in the center of chest or pain upon swallowing or difficulty swallowing. See your doctor as soon as possible if you have any of these effects

Uncommon (may affect up to 1 in 100 people):

•    soreness or pain in one or both eyes. You may have redness, blurred vision, watery eyes, a sensitivity to light or floaters (shadows passing across your sight)

Rare (may affect up to 1 in 1,000 people):

•    allergic reactions such as hives, swelling of the face, lips, tongue and/or throat, possibly causing difficulty breathing or swallowing (angioedema)

•    a skin condition with severe blisters and bleeding in the lips, eyes, mouth, nose and genitals (Stevens-Johnson syndrome) or severe skin reactions which starts with painful red areas, then large blisters and ends with peeling of layers of skin. This is accompanied by fever and chills, aching muscles and generally feeling unwell (toxic epidermal necrolysis)

•    pain in the mouth, and/or jaw, swelling or sores inside the mouth, numbness or a feeling of heaviness in the jaw, or loosening of a tooth. These could be signs of bone damage in the jaw (osteonecrosis) generally associated with delayed healing and infection, often following tooth extraction

•    unusual fracture of the thigh bone particularly in patients on long-term treatment for osteoporosis may occur rarely. Contact your doctor if you experience pain, weakness or discomfort in your thigh, hip or groin as this may be an early indication of a possible fracture of the thigh bone

Contact your doctor or dentist if you experience such symptoms.

Other possible side effects:

Very common (may affect more than 1 in 10 people):

•    bone, muscle and/or joint pain which is sometimes severe.

Common (may affect up to 1 in 10 people):

•    joint swelling, swelling of the hands and legs

•    abdominal pain, uncomfortable or full feeling in the stomach or belching after eating; constipation, diarrhoea, flatulence

•    hair loss, itchy skin

•    headache, dizziness, loss of balance or spinning sensation(vertigo), unusual weakness

Uncommon (may affect up to 1 in 100 people):

•    nausea, vomiting

•    rash, redness of the skin

•    for a short time flu-like symptoms, such as aching muscles, generally feeling unwell and sometimes with fever. This is usually seen at the start of treatment

•    changes in your taste.

Rare (may affect up to 1 in 1,000 people):

•    symptoms of low blood calcium levels including muscle cramps or spasms and/or tingling sensation in the fingers or around the mouth

•    narrowing of the gullet (oesophageal stricture)

•    rash made worse by sunlight

Tell your doctor or pharmacist promptly about these or any other unusual symptoms.

It will help if you make a note of what you experienced, when it started and how long it lasted.

Reporting of side effects

If you get any side effects, talk to your doctor or pharmacist. This includes any side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at www.mhra.gov.uk/yellowcard.

By reporting side effects you can help provide more information on the safety of this medicine.

5.    How to store Alendronic Acid

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiry date which is stated on the label, carton and blister after "EXP". The expiry date refers to the last day of that month.

This medicinal product does not require any special storage conditions.

Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

6.    Contents of the pack and other information

What Alendronic Acid contains:

Each tablet contains 70 mg of alendronic acid as the active substance sodium alendronate.

The other ingredients are lactose monohydrate; cellulose, microcrystalline; croscarmellose sodium; povidone and magnesium stearate.

What Alendronic Acid looks like and contents of the pack:

Alendronic Acid 70 mg Tablets are white, with two curved sides, marked as 'AD70' on one side and 'G' on the reverse.

Alendronic Acid 70 mg Tablets are available in blister packs and bottles of 4, 8 or 12 tablets. The bottles may contain a plastic spacer at the top of the pack.

Not all pack sizes and types may be marketed.

Marketing Authorisation Holder:

Mylan, Potters Bar, Hertfordshire, EN6 1TL,

United Kingdom.

Manufacturer:

Generics [UK] Limited, Station Close, Potters Bar, Hertfordshire, EN6 1TL, United Kingdom.

Gerard Laboratories, 35/36 Baldoyle Industrial Estate, Grange Road, Dublin 13, Ireland

This leaflet was last revised in 07/2014    450803

LT1517AH