Risedronate/calcium (By mouth)


Treats and prevents weak or brittle bones (osteoporosis) in women who have gone through menopause.

Brand Name(s)

Actonel with Calcium

There may be other brand names for this medicine.

When This Medicine Should Not Be Used

You should not use this medicine if you have had an allergic reaction to risedronate, or if levels of calcium in your blood are too low (hypocalcemia) or too high (hypercalcemia). Do not use this medicine if you have esophagus (the tube that runs from your throat to your stomach) problems, trouble swallowing, or severe kidney disease. You should not use this medicine if you are unable to stand or sit upright for at least 30 minutes after taking the medicine.

How to Use This Medicine

Tablet, Tablet

  • Your doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to.
  • The usual dose of this medicine is one Actonel® tablet each week and one calcium tablet every day except the day you take the Actonel® tablet.
  • If any of the Actonel® stays in your esophagus, it may cause serious damage. The esophagus is the tube that carries food from your mouth to your stomach when you swallow. To lower the risk of this problem, take the tablets exactly as directed below.
  • It is best to take this medicine on an empty stomach.
  • On the day you take your Actonel® tablet, take it as soon as you get out of bed in the morning, before you eat or have anything to drink. Swallow the tablet whole with a large glass (6 to 8 ounces) of plain water only (not mineral water, coffee, tea, soda, juice, or any other liquid). Do not chew or suck on the tablet. Take this medicine while you are sitting or standing. Do not lie down for at least 30 minutes after taking this medicine, and do not lie down until after you have eaten some food. Do not take the medicine while you are still in bed, and do not take it at bedtime.
  • Wait at least 30 minutes after you swallow the Actonel® tablet before you eat or drink anything or take any other medicines. This will help your body absorb the medicine.
  • On the day you take your calcium tablet, take it with food to help your body absorb the calcium.
  • Follow your dosing instructions given to you by your doctor closely. It may affect the way this medicine works if you do not. Do not stop using this medicine suddenly without asking your doctor.
  • Carefully follow your doctor's instructions about any special diet. Carefully follow your doctor's instructions about diet and exercise. It is especially important that you get enough calcium and vitamin D in your diet.
  • This medicine comes with patient instructions. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.
  • This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions. Ask your pharmacist for the Medication Guide if you do not have one.

If a dose is missed:

  • If you miss a dose or forget to take your Actonel® in the morning, skip the missed dose and take your medicine the next morning. Follow all of the usual instructions about taking it on an empty stomach and not lying down for at least 30 minutes. Then return to your regular Actonel® schedule the following week. Do not use extra medicine to make up for a missed dose. Never take two Actonel® tablets on the same day.
  • If you miss a dose or forget to take your calcium tablet, take it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use an extra tablet to make up for a missed dose.

How to Store and Dispose of This Medicine

  • Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
  • Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
  • Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • Do not use this medicine at the same time you use mineral supplements, iron, or antacids that contain aluminum, magnesium, or calcium (such as Maalox®, Mylanta®, or Tums®).
  • Make sure your doctor knows if you are also using pain or arthritis medicine (such as aspirin, ibuprofen, Advil®, Aleve®, Celebrex®, Ecotrin®, or Motrin®), vitamin D supplements (such as calcitriol, doxercalciferol, paricalcitol, or Rocaltrol®), thyroid replacement medicine (such as levothyroxine, Synthroid®), diuretics or "water pills" (such as hydrochlorothiazide [HCTZ]), tetracycline antibiotics (such as doxycycline, minocycline, Sumycin®, or Vibramycin®), an antibiotic (such as ciprofloxacin, moxifloxacin, ofloxacin, Ciloxan®, Cipro®, Levaquin®, or Tequin®), or a steroid medicine (such as dexamethasone, prednisolone, prednisone, or Medrol®).
  • This medicine may interact with the dye used for bone scans.

Warnings While Using This Medicine

  • Make sure your doctor knows if you are pregnant or breastfeeding, or if you have kidney disease, kidney stones, stomach ulcers, heartburn, or any other kind of stomach or bowel problems. Tell your doctor if you have poor oral hygiene, dental problems, or have trouble absorbing minerals in your stomach (malabsorption syndrome).
  • This medicine can irritate your esophagus. If you think this medicine has started to damage your esophagus, stop taking this medicine and call your doctor. Some symptoms of damage to the esophagus are heartburn (either new or worse than usual), pain when swallowing, pain in the center of your chest, trouble swallowing, or feeling that food gets stuck on the way to your stomach.
  • Your doctor will need to know if you have a history of problems with your mouth or teeth (such as gum disease). Make sure your doctor knows if you have been treated with a bisphosphonate medicine (such as alendronate, etidronate, ibandronate, or Fosamax®) in the past.
  • You may need to have a dental exam before you start using this medicine.
  • Make sure any doctor or dentist who treats you knows that you are using this medicine. You should avoid having major dental work done while you are being treated with this medicine.
  • Make sure you tell your doctor about any new medical problems, especially with your teeth or jaws. Tell your doctor if you have severe bone, joint, or muscle pain while using this medicine.
  • This medicine may increase your risk of developing fractures of the thigh bone. This may be more common if you use it for a long time. Check with your doctor right away if you have a dull or aching pain in the thighs, groin, or hips.
  • Tell your doctor if you do weight-bearing exercises, or smoke and/or drink excessively. Your doctor will need to take these into consideration in deciding your dose.
  • Your doctor will need to check your progress at regular visits while you are using this medicine. Be sure to keep all appointments.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
  • Blistering, peeling, or itchy skin rash
  • Blood in the urine, lower back pain, side pain, or sharp back pain just below the ribs
  • Change in how much or how often you urinate, burning or painful urination
  • Chest pain, heartburn, or burning in throat
  • Difficult or painful swallowing
  • Fast, slow, or uneven heartbeat
  • Fever, chills, cough, sore throat, and body aches
  • Increased thirst, loss of appetite, confusion, muscle weakness, nausea, or vomiting
  • Muscle twitching or tremors, feeling tired or irritable
  • Pain or other problems with your teeth or jaw
  • Severe bone, joint, or muscle pain
  • Unusual or severe stomach pain

If you notice these less serious side effects, talk with your doctor:

  • Blurred vision, eye problems
  • Depression
  • Dizziness
  • Headache
  • Mild back pain, neck pain, or joint pain
  • Mild nausea, gas, bloating, constipation, diarrhea, stomach pain, or stomach upset
  • Mild skin rash
  • Runny or stuffy nose

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Version Info

  • Last Reviewed on 06/12/2013

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