Alendronate: Dosage, Uses, and Side Effects

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Alendronate for Dogs and Cats: Dosage, Uses, and Side Effects Guide

Alendronate For Dogs And Cats: Dosage, Uses, And Side Effects Guide

Overview

Alendronate is a bisphosphonate that inhibits osteoclastic bone resorption, which helps manage conditions related to bone degradation and excessive calcium. It also inhibits angiogenesis, cancer cell division, and osteoclastogenesis, and induces apoptosis of osteoclasts.

Uses of Alendronate In Dogs and Cats

  • Cats:
    • Treatment of idiopathic hypercalcemia.
    • Management of feline tooth resorption.
  • Dogs:
    • Management of bone pain caused by osteolytic conditions (e.g., bone tumors or osteosarcoma).
    • Adjunct therapy for hypercalcemia.
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Alendronate Dose For Dogs, Cats, Pigs, and Birds

Species Condition Treated with Alendronate Dosage
Dogs Hypercalcemia 0.5โ€“1 mg/kg PO every 24 hours on an empty stomach
Bone pain (e.g., osteosarcoma) 10 mg/dog PO once daily
Osteosarcoma management (extra-label) 2 mg/kg PO once daily on an empty stomach
Cats Idiopathic hypercalcemia 5โ€“10 mg/cat PO weekly. Increase to 30 mg/cat PO if well tolerated
Tooth resorption 9 mg/kg PO twice per week

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You Should Give:

Common Side Effects of Alendronate In Dogs and Cats

  • Esophageal irritation or ulcers: Encourage drinking water post-dosing to minimize risks.
  • Gastrointestinal issues: Vomiting, inappetence, or anorexia.
  • Muscle and bone pain.
  • Hypocalcemia: Monitor calcium levels, particularly in patients receiving long-term treatment.
  • Osteonecrosis (rare, but reported in cats with prolonged use).

Contraindications of Alendronate In Dogs and Cats

  • Avoid use in animals with esophageal disease (e.g., esophagitis or stricture).
  • Use cautiously in patients with renal insufficiency; avoid use in renal failure.
  • Avoid concurrent use with calcium-containing supplements or medications, as they reduce alendronateโ€™s bioavailability.
  • Hypersensitivity to bisphosphonates is a contraindication.

Some Notes:

  1. Administration Guidelines:
    • Administer on an empty stomach with water only. Food reduces absorption by 60%.
    • Offer 6 mL water by syringe post-administration to prevent esophageal irritation.
    • For cats, butter the nasal planum to increase salivation and reduce esophageal transit time.
  2. Drug Interactions:
    • NSAIDs (e.g., meloxicam) may increase gastrointestinal risks.
    • Loop diuretics (e.g., furosemide) may increase the risk of hypocalcemia.
    • H2-receptor antagonists (e.g., ranitidine) increase alendronate levels.
    • Avoid concurrent use with proton pump inhibitors (e.g., omeprazole) as they may reduce alendronateโ€™s effectiveness.
  3. Monitoring Recommendations:
    • Monitor ionized calcium (iCa) levels regularly to maintain within the target range.
    • Evaluate for GI side effects during follow-ups, especially with long-term use.
    • Monthly monitoring is recommended during the first 6 months of therapy.
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