Prime Editing Unlocks a Universal Strategy for Restoring Lost Proteins
November 22, 2025
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Brand Name :
Binosto, Adrovance, Fosamax, Fosamax plus D, Fosavance
Synonyms :
ABDP, Acide Alendronique, Acido Alendronico, Acidum Alendronicum, Alendronate, alendronic acid
Class :
Musculo-skeletal system agent, Antiresorptive, Farnesylpyrophosphate synthetase inhibitor, Bisphosphonates
Brand Name :
Binosto, Adrovance, Fosamax, Fosamax plus D, Fosavance
Synonyms :
ABDP, Acide Alendronique, Acido Alendronico, Acidum Alendronicum, Alendronate, alendronic acid
Class :
Musculo-skeletal system agent, Antiresorptive, Farnesylpyrophosphate synthetase inhibitor, Bisphosphonates
Dosage Forms & StrengthsÂ
TabletÂ
5 mgÂ
10 mgÂ
35 mgÂ
70 mgÂ
Tablet (effervescent)Â
70 mgÂ
SolutionÂ
70 mg/75 mLÂ
It is employed in the management of osteoporosis, addressing this condition in postmenopausal women and men with a heightened risk of fractures
For males and postmenopausal females, the recommended dosage is 10 mg via oral administration once daily or 70 mg once weekly; Periodic re-evaluation of therapy is advised based on individual benefits and potential risks
For effervescent tablets, reconstitution involves dissolving the tablet in a half glass of plain water (at least 120 mL); Once effervescence ceases, wait for at least 5 minutes and stir the buffered solution for approximately 10 seconds if the tablet does not dissolve completely, ensuring clarity or slight cloudiness
Dose Adjustments
Renal dose adjustments:
This is not recommended for use in patients with renal impairment whose CrCl is less than 35 ml/min
40 mg once daily for six months; further doses may be required following the six-month post-treatment assessment period
For effervescent tablets, reconstitution involves dissolving the tablet in a half glass of plain water (at least 120 mL); Once effervescence ceases, wait for at least 5 minutes and stir the buffered solution for approximately 10 seconds if the tablet does not dissolve completely, ensuring clarity or slight cloudiness
Dose Adjustments
Renal dose adjustments:
This is not recommended for use in patients with renal impairment whose CrCl is less than 35 ml/min
Safety and efficacy are not seen in pediatricsÂ
Refer to the adult dosingÂ
It may decrease the effects of human parathyroid hormone
may diminish the serum concentration of polyvalent cation-containing products
may increase the risk or severity of adverse effects when combined
may diminish the serum concentration of Polyvalent Cation Containing Products
aluminum hydroxide/magnesium carbonateÂ
may decrease the serum concentration of Polyvalent Cation Containing Products
may decrease the serum concentration of Polyvalent Cation Containing Products
may enhance the risk of adverse effects when combined with alendronic acid
may decrease the effects of the drug by GI absorption inhibition
may decrease the effects of the drug by GI absorption inhibition
may decrease the effects of the drug by GI absorption inhibition
may decrease the effects of the drug by GI absorption inhibition
may decrease the effects of the drug by GI absorption inhibition
may decrease the effects of the drug by GI absorption inhibition
may decrease the effects of the drug by GI absorption inhibition
may decrease the effects of the drug by GI absorption inhibition
may decrease the effects of the drug by GI absorption inhibition
may decrease the effects of the drug by GI absorption inhibition
may increase GI bleeding, ulceration and irritation
may increase GI bleeding, ulceration and irritation
may increase GI bleeding, ulceration and irritation
may diminish the serum concentration of polyvalent cation-containing products
ribostamycin, when used with alendronic acid, can lead to a higher risk of nephrotoxicity and hypocalcemia
angiogenesis Inhibitors may enhance the adverse/toxic effect of bisphosphonate derivatives
angiogenesis Inhibitors may enhance the adverse/toxic effect of bisphosphonate derivatives
angiogenesis Inhibitors may enhance the adverse/toxic effect of bisphosphonate derivatives
angiogenesis Inhibitors may enhance the adverse/toxic effect of bisphosphonate derivatives
angiogenesis Inhibitors may enhance the adverse/toxic effect of bisphosphonate derivatives
may have an increasingly adverse effect when combined with bisphosphonate derivatives
may have an increasingly adverse effect when combined with bisphosphonate derivatives
may have an increasingly adverse effect when combined with bisphosphonate derivatives
may have an increasingly adverse effect when combined with bisphosphonate derivatives
may have an increasingly adverse effect when combined with bisphosphonate derivatives
When antrafenine is used together with alendronic acid, this leads to enhanced risk or seriousness of adverse outcomes
When alendronic acid is used together with proglumetacin, this leads to enhanced risk or seriousness of adverse events
when combined, Bisphosphonate Derivative's side effects can be increased with NSAIDs
when combined, Bisphosphonate Derivative's side effects can be increased with NSAIDs
when combined, Bisphosphonate Derivative's side effects can be increased with NSAIDs
when combined, Bisphosphonate Derivative's side effects can be increased with NSAIDs
when combined, Bisphosphonate Derivative's side effects can be increased with NSAIDs
When alendronic acid is used together with benoxaprofen, this leads to enhanced risk or seriousness of adverse events
When alendronic acid is used together with fenbufen, this leads to enhanced risk or seriousness of adverse events
When alendronic acid is used together with aluminium phosphate, this leads to a reduction in the concentration serum of alendronic acid
may have an increasingly adverse effect when combined with bisphosphonate derivatives
the likelihood or intensity of adverse effects may increase when aceclofenac is used in combination with alendronic acid
When alendronic acid is used together with calcium levulinate, this leads to reduced concentration serum of alendronic acid
When alendronic acid is used together with nifenazone, this leads to enhanced risk or seriousness of adverse events
When alendronic acid is used together with difenpiramide, this leads to increased risk or seriousness of adverse events
the combination of roquinimex with alendronic acid may heighten the chances of jaw osteonecrosis and anti-angiogenesis
the risk or extent of jaw osteonecrosis and anti-angiogenesis can be raised when volociximab is combined with alendronic acid
May enhance the toxic effects of the other by pharmacodynamic synergism
May enhance the toxic effects of the other by pharmacodynamic synergism
NSAIDs may enhance the adverse/toxic effect of Bisphosphonate Derivatives
NSAIDs may enhance the adverse/toxic effect of Bisphosphonate Derivatives
NSAIDs may enhance the adverse/toxic effect of Bisphosphonate Derivatives
NSAIDs may enhance the adverse/toxic effect of Bisphosphonate Derivatives
NSAIDs may enhance the adverse/toxic effect of Bisphosphonate Derivatives
NSAIDs increase the toxicity of bisphosphonate derivatives
NSAIDs increase the toxicity of bisphosphonate derivatives
NSAIDs increase the toxicity of bisphosphonate derivatives
NSAIDs increase the toxicity of bisphosphonate derivatives
NSAIDs increase the toxicity of bisphosphonate derivatives
they increase the effect of hypocalcemia in bisphosphonate derivatives
they increase the effect of hypocalcemia in bisphosphonate derivatives
they increase the effect of hypocalcemia in bisphosphonate derivatives
they increase the effect of hypocalcemia in bisphosphonate derivatives
they increase the effect of hypocalcemia in bisphosphonate derivatives
they increase the toxicity of bisphosphonate derivatives
they increase the toxicity of bisphosphonate derivatives
they increase the toxicity of bisphosphonate derivatives
they increase the toxicity of bisphosphonate derivatives
they increase the toxicity of bisphosphonate derivatives
bisphosphonate derivatives increase the toxicity of deferasirox
may enhance the adverse/toxic effect of bisphosphonate derivatives
may enhance the adverse/toxic effect of bisphosphonate derivatives
may enhance the adverse/toxic effect of bisphosphonate derivatives
may enhance the adverse/toxic effect of bisphosphonate derivatives
may enhance the adverse/toxic effect of bisphosphonate derivatives
may diminish the therapeutic effect of bisphosphonate derivative
may diminish the therapeutic effect of bisphosphonate derivative
may diminish the therapeutic effect of bisphosphonate derivative
may diminish the therapeutic effect of bisphosphonate derivative
may diminish the therapeutic effect of bisphosphonate derivative
may enhance the adverse/toxic effect of bisphosphonate derivatives
may enhance the adverse/toxic effect of bisphosphonate derivatives
may enhance the adverse/toxic effect of bisphosphonate derivatives
may enhance the adverse/toxic effect of bisphosphonate derivatives
may enhance the adverse/toxic effect of bisphosphonate derivatives
may enhance the hypocalcemic effect of bisphosphonate derivatives
may enhance the hypocalcemic effect of bisphosphonate derivatives
may enhance the hypocalcemic effect of bisphosphonate derivatives
may enhance the hypocalcemic effect of bisphosphonate derivatives
may enhance the hypocalcemic effect of bisphosphonate derivatives
may enhance the risk of adverse effect of bisphosphonate derivatives
may enhance the risk of adverse effect of bisphosphonate derivatives
may enhance the risk of adverse effect of bisphosphonate derivatives
may enhance the risk of adverse effect of bisphosphonate derivatives
may enhance the risk of adverse effect of bisphosphonate derivatives
may diminish the therapeutic effect of bisphosphonate derivatives
may diminish the therapeutic effect of bisphosphonate derivatives
may diminish the therapeutic effect of bisphosphonate derivatives
may diminish the therapeutic effect of bisphosphonate derivatives
may diminish the therapeutic effect of bisphosphonate derivatives
may increase the hypo calcaemic effect
may increase the toxic effect of non-steroidal anti-inflammatory drugs
may increase the toxic effect of nonsteroidal anti-inflammatory agents
may increase the toxic effect of angiogenesis inhibitors
may increase the risk of adverse effects
may increase the risk of adverse effects
may increase the risk of adverse effects
may increase the risk of adverse effects
may increase the risk of adverse effects
Inhibitors of the Proton Pump: they may decrease the therapeutic effect of oral bisphosphonate derivatives
Inhibitors of the Proton Pump: they may decrease the therapeutic effect of oral bisphosphonate derivatives
Inhibitors of the Proton Pump: they may decrease the therapeutic effect of oral bisphosphonate derivatives
Inhibitors of the Proton Pump: they may decrease the therapeutic effect of oral bisphosphonate derivatives
Inhibitors of the Proton Pump: they may decrease the therapeutic effect of oral bisphosphonate derivatives
aminoglycosides increase the effect of hypocalcemia of bisphosphonate derivatives
neomycin/polymyxin B/bacitracin topical
aminoglycosides increase the effect of hypocalcemia of bisphosphonate derivatives
aminoglycosides increase the effect of hypocalcemia of bisphosphonate derivatives
aminoglycosides increase the effect of hypocalcemia of bisphosphonate derivatives
aminoglycosides increase the effect of hypocalcemia of bisphosphonate derivatives
It may increase the nephrotoxic effect when combined with Bisphosphonate Derivatives
It may increase the toxic effect when combined with Bisphosphonate Derivatives
It may enhance the risk of adverse effects when combined with Phosphodiesterase inhibitors
the risk or severity of adverse effects may increase when acemetacin is combined with alendronic acid
the risk or severity of adverse effects may increase when acetylsalicylic acid is combined with alendronic acid
the risk or severity of myopathy, rhabdomyolysis, and myoglobinuria can increase when alendronic acid is combined with acipimox
the risk or severity of nephrotoxicity and hypocalcemia can increase when acyclovir is combined with alendronic acid
the risk or severity of myopathy, rhabdomyolysis, and myoglobinuria can increase when carbimazole is combined with alendronic acid
the risk or severity of nephrotoxicity and hypocalcemia can increase when carboplatin is combined with alendronic acid
the risk or severity of adverse effects may increase when carprofen is combined with alendronic acid
the risk or severity of nephrotoxicity and hypocalcemia can increase when cefaclor is combined with alendronic acid
the risk or severity of nephrotoxicity and hypocalcemia can increase when cefadroxil is combined with alendronic acid
the risk or severity of adverse effects may increase when valdecoxib is combined with alendronic acid
the risk or severity of nephrotoxicity and hypocalcemia can increase when vancomycin is combined with alendronic acid
the risk or severity of myopathy, rhabdomyolysis, and myoglobinuria can increase when vincristine is combined with alendronic acid
the risk or severity of myopathy, rhabdomyolysis, and myoglobinuria can increase when zidovudine is combined with alendronic acid
the presence of ferrous bisglycinate may reduce the absorption of alendronic acid, leading to a diminished serum concentration and potentially compromising its efficacy
ferrous succinate has the potential to impair the absorption of alendronic acid, which could compromise its efficacy by lowering serum levels
may have an increasingly adverse effect when combined with bisphosphonate derivatives
the risk of anti-angiogenesis and jaw osteonecrosis may be increased
the risk of anti-angiogenesis and jaw osteonecrosis may be increased
combining beloranib with alendronic acid may heighten the risk or severity of jaw osteonecrosis and anti-angiogenesis
imidazole salicylate and alendronic acid together may raise the possibility of negative side effects
the risk of adverse effects may be increased
May enhance the toxic effects of the other by pharmacodynamic synergism
May enhance the toxic effects of the other by pharmacodynamic synergism
may have an increasingly adverse effect when combined with bisphosphonate derivatives
Actions and Spectrum:Â
Actions:Â
One type of bisphosphonate is alendronic acid. It functions by reducing the activity of osteoclasts, which are bone-degrading cells. This reduces the chance of fractures and strengthens the bones.Â
Spectrum:Â
Alendronic acid demonstrates its efficacy in addressing osteoporosis, a condition marked by weakened bones. It primarily targets osteoclast activity, inhibiting bone resorption and contributing to the maintenance or increase of bone density. This mechanism helps diminish the risk of fractures. Apart from osteoporosis, alendronic acid may be prescribed for other bone-related conditions like Paget’s disease and glucocorticoid-induced osteoporosis.Â
Frequency not definedÂ
AlopeciaÂ
Oesophageal ulcersÂ
PruritisÂ
OesophagitisÂ
Osteonecrosis of jaw and external auditory canalÂ
Muscle painÂ
Oesophageal erosionsÂ
Severe bone, joint painÂ
Decreased serum Ca and PÂ
Stevens-johnson syndromeÂ
Gastric and duodenal ulcersÂ
Toxic epidermal necrolysisÂ
Atypical subtrochanteric and diaphyseal femoral fractures on prolonged useÂ
VertigoÂ
DiarrheaÂ
HeadacheÂ
Abdominal painÂ
DyspepsiaÂ
Abdominal distentionÂ
FlatulenceÂ
Acid regurgitationÂ
Peripheral edemaÂ
AstheniaÂ
DizzinessÂ
Black Box Warning:Â
 In case you have experienced an allergic reaction to this medication, avoid using it again. Retaking it might be deadly (cause death).Â
Contraindication/Caution:Â
ContraindicationsÂ
HypersensitivityÂ
HypocalcemiaÂ
Increased risk of aspirationÂ
AchalasiaÂ
strictureÂ
CautionsÂ
Pregnancy consideration:Â Â
No data is available regarding the administration of the drug during pregnancy.Â
Breastfeeding warnings:Â Â
No data is available regarding the excretion of drug in breast milk.Â
Pregnancy category: CÂ
Category A: well-controlled and satisfactory studies show no risk to the fetus in the first or later trimester.Â
Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women.Â
Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.   Â
Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.   Â
Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.   Â
Category N: No data is available for the drug under this category.Â
Pharmacology:Â
An aminobisphosphonate called alendronic acid reduces the activity of osteoclasts or osteoclast precursors, slowing down the rate of bone resorption and indirectly increasing bone mineral density. Inhibition of resorption results in an indirect reduction in bone formation; nevertheless, the newly created bone has a more normal structure. This is the mechanism of action in Paget’s disease.Â
Pharmacodynamics:Â
Hydroxyapatite in bone is bound by alendronic acid. Osteoclasts take up alendronic acid through fluid-phase endocytosis, which is released during bone resorption and results in local acidity. When endocytic vesicles get acidified, alendronic acid is released into the cytosol of osteoclasts, where it causes apoptosis. Reduced urine calcium, deoxypyridinoline, and cross-linked N-telopeptidases of type I collagen are indicators of reduced bone resorption brought on by inhibition of osteoclasts. Â
Pharmacokinetics:Â
AbsorptionÂ
inadequately absorbed from the digestive system. 0.6% bioavailability in a fasting condition. Foods and goods with polyvalent cations or calcium content may make absorption less effective. Â
DistributionÂ
Distribution volume: 28 L (not including the bone). Binding of plasma proteins: about 78%. MetabolismÂ
Not metabolized.Â
Elimination and ExcretionÂ
By urine and feces (as unabsorbed medication). >10 years is the elimination half-life.Â
Administration:Â
Must be consumed without food. Take with a full glass of plain water at least half an hour before the first meal, drink, or medication of the day, and stay seated or upright for at least half an hour after that. Consume whole; do not break or chew.Â
Patient information leafletÂ
Generic Name: alendronic acidÂ
Pronounced: uh-LEN-dron-ik AS-idÂ
Alendronic acid, classified as a bisphosphonate medication, is primarily employed for the treatment and prevention of osteoporosis. Osteoporosis involves the weakening of bones, rendering them more susceptible to fractures, and is commonly associated with postmenopausal women, though it can affect men as well.Â
The mechanism of action of alendronic acid involves the inhibition of osteoclasts, cells responsible for the breakdown of bone tissue. By slowing down bone resorption, alendronic acid contributes to the maintenance or increase of bone density, ultimately reducing the risk of fractures.Â
Beyond osteoporosis, healthcare providers may prescribe alendronic acid for other bone-related conditions like Paget’s disease and glucocorticoid-induced osteoporosis. This oral medication is typically taken weekly or monthly, following the guidance of a healthcare professional.Â
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