Anti-Paget's disease
Generic and Trade Names:
| Alendronate | Fosamax | |
| Calcitonin | Calcimar, Miacalcin | |
| Etidronate | Didronel | |
| Pamidronate | Aredia | |
| Residronate | Actonel | |
| Tiludronate | Skelid |
Description:
Paget's disease is characterized by chronic areas of bone destruction complicated by weakened bones that may fracture or bend under stress. Signs include: bone pain, fractures, neurological disorders, increased serum alkaline phosphatase levels (reflecting increased bone formation). (Facts and Comparisons 1999)
The biphosphonate class of drugs are used to improve bone, by the inhibition of normal and abnormal bone resorption. Drugs in this class include: Fosamax, Actonel and others.(Facts and Comparisons 1999)
Calcitonin is naturally part of bone metabolism. Exogenous sources may be from pork, salmon or humans. Calcitonin is a potent inhibitor of bone resorption.
Nutritional Considerations:
Supplements of calcium and vitamin D should be considered to enhance the benefits, however they should not be taken within 1 hour of the drugs. (Facts and Comparisons 1999) (Pronsky 1999)
Magnesium levels may increase with Calcitonin because the drug can reduce magnesium clearance. (Shils 1994)
Avoid tea and coffee . (Kynast-Gales, 1994)
Biphosphonates should be taken with plain water first thing in the morning on an empty stomach, 30 minutes before any food consumption.
Take alendronate with a full glass of water, and do not lie down for 30 minutes following taking the medication. (Facts and Comparisons 1999)
Avoid excessive cigarette smoking or alcohol consumption. (Facts and Comparisons 1999)
Calcitriol can improve and nearly normalize the impaired calcitonin secretion of the mildly vitamin D-deficient elderly subjects without changes in serum calcium. (Quesada, 1994)
Herbal Considerations
No herbal considerations at this time
References
Baran DT: Osteoporosis: monitoring techniques and alternate therapies. Calcitonin, fluoride, bisphosphonates, vitamin D. Obstet Gynecol Clin North Am, 1994 Jun, 21:2, 321-35.
Facts and Comparisons. Clinispere 2.0, Wolters Kluwer Company, 1999.
Kynast-Gales SA, Massey LK. Effect of caffeine on circadian excretion of urinary calcium and magnesium. J Am Coll Nutr 1994;13:467-72.
Pronsky, ZM: Food-Medication Interactions,11th edition, 1999
Quesada JM et al., Calcitriol corrects deficient calcitonin secretion in the vitamin D-deficient elderly. J Bone Miner Res, 1994 Jan, 9:1, 53-7.
Reginster JY: Treatment of bone in elderly subjects: calcium, vitamin D, fluor, bisphosphonates, calcitonin. Horm Res, 1995, 43:1-3, 83-8.
Shils M, Olson A, Shike M. Modern Nutrition in Health and Disease. 8th ed. Philadelphia, PA: Lea and Febiger ; 1994.
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