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calcium carbonate and risedronate

Pronunciation: KAL see um KAR bo nate and rye SED roe nate

Brand: Actonel with Calcium

Actonel with Calcium

oval, blue/orange, imprinted with RSN 35 mg, NE2

Image of Actonel with Calcium
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What is the most important information I should know about calcium carbonate and risedronate?

Actonel with Calcium is packaged as two separate medicines: 4 risedronate tablets and 24 calcium tablets. Take a risedronate tablet one day per week, first thing in the morning, at least 30 minutes before you eat or drink anything or take any other medicine. Take a calcium tablet with food every day for the 6 days in between your risedronate doses. Only the calcium tablet should be taken with food. Risedronate must be taken on an empty stomach.

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Do not take a risedronate tablet if you cannot sit upright or stand for at least 30 minutes. Risedronate can cause serious problems in the stomach or esophagus (the tube that connects your mouth and stomach). You will need to stay upright for at least 30 minutes after taking this medication.

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Take each dose with a full glass (6 to 8 ounces) of water. Use only plain water (not mineral water) when taking a risedronate tablet.

For at least the first 30 minutes after taking a risedronate tablet, do not lie down or recline, do not eat or drink anything other than plain water, and do not take any other medicines including vitamins, calcium, or antacids.

Some people using medicines similar to risedronate have developed bone loss in the jaw, also called osteonecrosis of the jaw. Symptoms of this condition may include jaw pain, swelling, numbness, loose teeth, gum infection, or slow healing after injury or surgery involving the gums. You may be more likely to develop osteonecrosis of the jaw if you have cancer or have been treated with chemotherapy, radiation, or steroids. Other conditions associated with osteonecrosis of the jaw include blood clotting disorders, anemia (low red blood cells), and a pre-existing dental problem.

Take only the amount of calcium that your doctor recommends. Do not use other calcium supplements unless your doctor has told you to.

Talk with your doctor about the risks and benefits of using this medication.

What is calcium carbonate and risedronate?

Risedronate is in the group of medicines called bisphosphonates (bis FOS fo nayts). It alters the cycle of bone formation and breakdown in the body. Risedronate slows bone loss while increasing bone mass, which may prevent bone fractures.

Calcium is a mineral that is needed for many functions of the body, especially bone formation and maintenance.

Risedronate is used to treat or prevent postmenopausal and steroid-induced osteoporosis. Risedronate is also used to treat Paget's disease of bone.

Calcium carbonate is used to prevent and to treat calcium deficiencies.

Calcium carbonate and risedronate may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking calcium carbonate and risedronate?

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Do not take a risedronate tablet if you cannot sit upright or stand for at least 30 minutes. Risedronate can cause serious problems in the stomach or esophagus (the tube that connects your mouth and stomach). You will need to stay upright for at least 30 minutes after taking this medication.

To make sure you can safely take risedronate, tell your doctor if you have any of these other conditions:

  • low or high levels of calcium in your blood;
  • kidney disease;
  • trouble swallowing; or
  • an ulcer in your stomach or esophagus.

Some people using medicines similar to risedronate have developed bone loss in the jaw, also called osteonecrosis of the jaw. Symptoms of this condition may include jaw pain, swelling, numbness, loose teeth, gum infection, or slow healing after injury or surgery involving the gums.

You may be more likely to develop osteonecrosis of the jaw if you have cancer or have been treated with chemotherapy, radiation, or steroids. Other conditions associated with osteonecrosis of the jaw include blood clotting disorders, anemia (low red blood cells), and dental surgery or pre-existing dental problems.

Talk with your doctor about the risks and benefits of using this medication.

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FDA pregnancy category C. It is not known whether calcium carbonate and risedronate will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

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It is not known whether calcium carbonate and risedronate passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take calcium carbonate and risedronate?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Actonel with Calcium is packaged as two separate medicines: 4 risedronate tablets and 24 calcium tablets. Take a risedronate tablet one day per week, first thing in the morning, at least 30 minutes before you eat or drink anything or take any other medicine. Take a calcium tablet with food every day for the 6 days in between your risedronate doses.

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Only the calcium tablet should be taken with food. Risedronate must be taken on an empty stomach.

Take the risedronate tablet first thing in the morning, at least 30 minutes before you eat or drink anything or take any other medicine. Take the risedronate tablet on the same day each week and always first thing in the morning.

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Take the risedronate tablet with a full glass (6 to 8 ounces) of water. Use only plain water (not mineral water) when taking a risedronate tablet.

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Do not crush, chew, or suck the risedronate tablet. Swallow the pill whole.

After taking a risedronate tablet, carefully follow these instructions:

  • Do not lie down or recline for at least 30 minutes.
  • Do not eat or drink anything other than plain water.
  • Do not take any other medicines including vitamins, calcium, or antacids for at least 30 minutes. It may be best to take your other medicines at a different time of the day. Talk with your doctor about the best dosing schedule for your other medicines.

Your bone mineral density will need to be checked often. You may not need to take this medication for longer than 3 to 5 years if you take it for osteoporosis. Visit your doctor regularly.

Calcium carbonate and risedronate is only part of a complete program of treatment that may also include diet changes, exercise, and taking vitamin supplements. Follow your diet, medication, and exercise routines very closely.

Take only the amount of calcium that your doctor recommends. Do not use other calcium supplements unless your doctor has told you to.

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Store at room temperature away from moisture and heat.

What happens if I miss a dose?

If you forget to take a risedronate tablet: If you forget to take this medicine first thing in the morning, do not take it later in the day. Wait until the following morning to take the medicine and skip the missed dose. Do not take two (2) tablets in one day.

If you forget to take a calcium carbonate tablet: Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

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Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Drink a full glass of milk and call your local poison control center or emergency room right away. Do not make yourself vomit and do not lie down.

Overdose symptoms may include nausea, heartburn, stomach pain, diarrhea, muscle cramps, numbness or tingling, tight muscles in your face, seizure (convulsions), irritability, and unusual thoughts or behavior.

What should I avoid while taking calcium carbonate and risedronate?

Do not take any other medicines including vitamins, calcium, or antacids for at least 30 minutes after taking a risedronate tablet.

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Do not take an iron supplement at the same time you take a calcium tablet. Take these minerals at separate times of the day.

What are the possible side effects of calcium carbonate and risedronate?

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Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

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Stop using this medication and call your doctor at once if you have a serious side effect such as:

  • chest pain;
  • difficulty or pain when swallowing;
  • pain or burning under the ribs or in the back;
  • new or worsening heartburn;
  • severe joint, bone, or muscle pain;
  • new or unusual pain in your thigh or hip; or
  • jaw pain, numbness, or swelling.

Less serious side effects may include:

  • mild heartburn, nausea, or stomach upset;
  • diarrhea, gas, or constipation;
  • muscle, joint, or back pain;
  • pain or burning with urination;
  • mild skin rash; or
  • headache or depressed mood.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect calcium carbonate and risedronate?

Tell your doctor about all other medicines you use, especially:

  • levothyroxine (Synthroid);
  • diuretics (water pills);
  • steroids (prednisone and others);
  • an antibiotic such as ciprofloxacin (Cipro), doxycycline (Doryx, Oracea, Periostat, Vibramycin), levofloxacin (Levaquin), minocycline (Minocin), moxifloxacin (Avelox), ofloxacin (Floxin), tetracycline (Ala-Tet, Brodspec, Panmycin, Sumycin, Tetracap), and others; or
  • aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as celecoxib (Celebrex), diclofenac (Voltaren), diflunisal (Dolobid), ibuprofen (Motrin, Advil), indomethacin, ketoprofen (Orudis), ketorolac (Toradol), naproxen (Aleve, Naprosyn), piroxicam (Feldene), and others.

This list is not complete and other drugs may interact with calcium carbonate and risedronate. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

Your pharmacist can provide more information.


Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

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