Alendronate and risedronate: what you need to know about their upper gastrointestinal tract toxicity

Adverse upper gastrointestinal (GI) tract events can occur with alendronate or risedronate therapy. Although the short-term, non-placebo-controlled comparisons of alendronate and risedronate indicated that risedronate therapy may be associated with a lower risk of upper GI toxicity than alendronate therapy, the placebo-controlled comparison shows no difference in the risk of upper GI toxicity between the two drugs. The risk of an adverse upper GI event increases when these drugs are used concurrently with nonsteroidal anti-inflammatory drug (NSAID) therapy, but this incidence is no more than that observed with concurrent placebo and NSAID therapy. Also, the risk of these adverse GI tract events can be decreased by following the dosing instructions (e.g., avoid lying down for 30 minutes after taking the drug and take the drug with a full glass of water) and may be decreased with once-weekly dosing.