Can you take bisphosphonates with kidney disease?

About 50% to 80% of free bisphosphonates are incorporated into bone. Because of their urinary elimination, bisphosphonates must be carefully administered in chronic kidney disease (CKD) patients. In spite of this, bisphosphonates can safely be used in all CKD stages, including dialysis and kidney transplant.

Which bisphosphonate is safe in CKD?

Risedronate and ibandronate, which have a lower incidence of nephrotoxicity, have been studied in CKD patients with CrCl <30 mg/mL. Ibandronate has been studied in hemodialysis patients and was well tolerated, which suggests that this agent could be an option for patients with CKD and osteoporosis.

Is bisphosphonates contraindicated in renal failure?

However, the United States Food and Drug Administration safety reports have highlighted the issue of renal safety in bisphosphonate-treated patients. All bisphosphonates carry labeled “warnings” or a contraindication for use in patients with severe renal impairment (creatinine clearance <30 or <35 mL/min).

Can you take Fosamax if you have CKD?

To minimize the risk of chronic kidney disease (CKD) progressing to end-stage renal disease (ESRD), such osteoporosis medications as alendronate (Fosamax) and ibandronate (Boniva) are contraindicated in individuals whose glomerular filtration rate (GFR) is <30%.

Can you take Prolia with CKD?

These and other clinical data suggest that denosumab can be safely administered to patients with CKD-associated osteoporosis as long as patients are supplemented with vitamin D, have adequate calcium intake, and are monitored for hypocalcemia.

Are bisphosphonates nephrotoxic?

Bisphosphonates are valuable agents for the treatment of post-menopausal osteoporosis (PMO), hypercalcemia of malignancy, and osteolytic bone metastases. Oral bisphosphonates are used mainly to treat PMO and are not associated with significant nephrotoxicity.

When are bisphosphonates contraindicated?

Avoid oral bisphosphonates in patients with esophageal disorders such as achalasia, esophageal stricture, esophageal varices, Barrett’s esophagus, inability to stand or sit upright for at least 30 minutes, history of bariatric surgery (Roux-en-Y gastric bypass).

Are bisphosphonates hard on kidneys?

Nevertheless in the doses that are registered for the management of postmenopausal osteoporosis (PMO), oral bisphosphonates have never been shown to adversely affect the kidney, even (in post-hoc analysis of clinical trial data) down to estimated glomerular filtration rates of 15 ml/min.

Is Prolia contraindicated in renal failure?

Hypocalcemia following Prolia administration is a significant risk in patients with severe renal impairment (creatinine clearance < 30 mL/min) or receiving dialysis. These patients may also develop marked elevations of serum parathyroid hormone (PTH).

Should bisphosphonates be taken with food?

Bisphosphonates should be taken alone on an empty stomach first thing in the morning with at least 240 mL (8 oz) of water. After administration, the patient should not have food, drink, medications, or supplements for at least one half-hour (alendronate, risedronate) or one hour (ibandronate).

Categories: Common