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Adrovance (alendronate sodium trihydrate / colecalciferol) – Package leaflet - M05BB03

Updated on site: 11-Jul-2017

Medication nameAdrovance
ATC CodeM05BB03
Substancealendronate sodium trihydrate / colecalciferol
ManufacturerMerck Sharp

Package Leaflet: Information for the user

ADROVANCE 70 mg/2,800 IU tablets

ADROVANCE 70 mg/5,600 IU tablets

Alendronic acid /colecalciferol

Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.

-Keep this leaflet. You may need to read it again.

-If you have any further questions, ask your doctor or pharmacist.

-This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.

-If you get any side effects talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.

-It is particularly important to understand the information in section 3 before taking this medicine.

What is in this leaflet

1.What ADROVANCE is and what it is used for

2.What you need to know before you take ADROVANCE

3.How to take ADROVANCE

4.Possible side effects

5 How to store ADROVANCE

6.Contents of the pack and other information

1.What ADROVANCE is and what it is used for

What is ADROVANCE?

ADROVANCE is a tablet containing the two active substances, alendronic acid (commonly called alendronate) and colecalciferol known as vitamin D3.

What is alendronate?

Alendronate belongs to a group of non-hormonal medicines called bisphosphonates. Alendronate prevents the loss of bone that occurs in women after they have been through the menopause, and helps to rebuild bone. It reduces the risk of spine and hip fractures.

What is vitamin D?

Vitamin D is an essential nutrient, required for calcium absorption and healthy bones. The body can only absorb calcium properly from our food if it has enough vitamin D. Very few foods contain vitamin D. The main source is through exposure to summer sunlight, which makes vitamin D in our skin. As we get older our skin makes less vitamin D. Too little vitamin D may lead to bone loss and osteoporosis. Severe vitamin D deficiency may cause muscle weakness which can lead to falls and a greater risk of fractures.

What is ADROVANCE used for?

Your doctor has prescribed ADROVANCE to treat your osteoporosis and because you are at risk of vitamin D insufficiency. It reduces the risk of spine and hip fractures in women after menopause.

What is osteoporosis?

Osteoporosis is a thinning and weakening of the bones. It is common in women after the menopause. At the menopause, the ovaries stop producing the female hormone, oestrogen, which helps to keep a woman’s skeleton healthy. As a result, bone loss occurs and bones become weaker. The earlier a woman reaches the menopause, the greater the risk of osteoporosis.

Early on, osteoporosis usually has no symptoms. If left untreated, however, it can result in broken bones. Although these usually hurt, breaks in the bones of the spine may go unnoticed until they cause height loss. Broken bones can happen during normal, everyday activity, such as lifting, or from minor injury that would not generally break normal bone. Broken bones usually occur at the hip, spine, or wrist and can lead not only to pain but also to considerable problems like stooped posture (‘dowager’s hump’) and loss of mobility.

How can osteoporosis be treated?

As well as your treatment with ADROVANCE, your doctor may suggest you make changes to your lifestyle to help your condition, such as:

Stopping smoking

Smoking appears to increase the rate at which you lose bone and, therefore,

 

may increase your risk of broken bones.

Exercise

Like muscles, bones need exercise to stay strong and healthy. Consult your

 

doctor before you begin any exercise programme.

Eating a balanced diet Your doctor can advise you about your diet or whether you should take any dietary supplements.

2. What you need to know before you take ADROVANCE

Do not take ADROVANCE

if you are allergic to alendronic acid, colecalciferol or any of the other ingredients of this medicine (listed in section 6),

if you have certain problems with your gullet (oesophagus - the tube that connects your mouth with your stomach) such as narrowing or difficulty swallowing,

if you cannot stand or sit upright for at least 30 minutes,

if your doctor has told you that you have low blood calcium.

If you think any of these apply to you, do not take the tablets. Talk to your doctor first and follow the advice given.

Warnings and precautions

Talk to your doctor or pharmacist before taking ADROVANCE if:

you suffer from kidney problems,

you have, or have recently had, any swallowing or digestive problems,

your doctor has told you that you have Barrett's oesophagus (a condition associated with changes in the cells that line the lower oesophagus),

you have been told you have trouble absorbing minerals in your stomach or intestines (malabsorption syndrome),

you have poor dental health, gum disease, a planned dental extraction or you don’t receive routine dental care,

you have cancer,

you are undergoing chemotherapy or radiotherapy,

you are taking angiogenesis inhibitors (such as bevacizumab, or thalidomide) which are used in the treatment of cancer,

you are taking corticosteroids (such as prednisone or dexamethasone) which are used in the treatment of such conditions as asthma, rheumatoid arthritis, and severe allergies,

you are or have been a smoker (as this may increase the risk of dental problems).

You may be advised to have a dental check-up before starting treatment with ADROVANCE.

It is important to maintain good oral hygiene when being treated with ADROVANCE. You should have routine dental check-ups throughout your treatment and you should contact your doctor or dentist if you experience any problems with your mouth or teeth such as loose teeth, pain or swelling.

Irritation, inflammation or ulceration of the gullet (oesophagus – the tube that connects your mouth with your stomach) often with symptoms of chest pain, heartburn, or difficulty or pain upon swallowing may occur, especially if patients do not drink a full glass of water and/or if they lie down less than 30 minutes after taking ADROVANCE. These side effects may worsen if patients continue to take ADROVANCE after developing these symptoms.

Children and adolescents

ADROVANCE should not be given to children and adolescents less than 18 years of age.

Other medicines and ADROVANCE

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.

It is likely that calcium supplements, antacids, and some oral medicines will interfere with the absorption of ADROVANCE if taken at the same time. Therefore, it is important that you follow the advice given in section 3 and wait at least 30 minutes before taking any other oral medicines or supplements.

Certain medicines for rheumatism or long-term pain called NSAIDs (e.g. acetylsalicylic acid or ibuprofen) might cause digestive problems. Therefore, caution should be used when these medicines are taken at the same time as ADROVANCE.

It is likely that certain medicines or food additives may prevent the vitamin D in ADROVANCE from getting into your body, including artificial fat substitutes, mineral oils, the weight loss medicine, orlistat, and the cholesterol-lowering medicines, cholestyramine and colestipol. Medicines for fits (seizures) (like phenytoin or phenobarbital) may decrease the effectiveness of vitamin D. Additional vitamin D supplements may be considered on an individual basis.

ADROVANCE with food and drink

It is likely that food and beverages (including mineral water) will make ADROVANCE less effective if taken at the same time. Therefore, it is important that you follow the advice given in section 3. You must wait at least 30 minutes before taking any food and beverages except water.

Pregnancy and breast-feeding

ADROVANCE is only intended for use in postmenopausal women. You should not take ADROVANCE if you are or think you may be pregnant, or if you are breast-feeding.

Driving and using machines

There have been side effects (for example blurred vision, dizziness and severe bone, muscle or joint pain) reported with ADROVANCE that may affect your ability to drive or operate machinery (see section 4). If you experience any of these side effects you should not drive until you feel better.

ADROVANCE contains lactose and sucrose.

If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicine.

3.How to take ADROVANCE

Always take ADROVANCE exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.

Take one ADROVANCE tablet once a week.

Follow these instructions carefully.

1)Choose the day of the week that best fits your schedule. Every week, take one ADROVANCE tablet on your chosen day.

It is very important to follow instructions 2), 3), 4) and 5) to help the ADROVANCE tablet reach your stomach quickly and help reduce the chance of irritating your gullet (oesophagus - the tube that connects your mouth with your stomach).

2)After getting up for the day and before taking any food, drink, or other medicine, swallow your ADROVANCE tablet whole with a full glass of water only (not mineral water) (not less than 200 ml), so that ADROVANCE is adequately absorbed.

Do not take with mineral water (still or sparkling).

Do not take with coffee or tea.

Do not take with juice or milk.

Do not crush or chew the tablet or allow it to dissolve in your mouth because of the possibility of mouth ulceration.

3)Do not lie down — stay fully upright (sitting, standing or walking) — for at least 30 minutes after swallowing the tablet. Do not lie down until after your first food of the day.

4)Do not take ADROVANCE at bedtime or before getting up for the day.

5)If you develop difficulty or pain upon swallowing, chest pain, or new or worsening heartburn, stop taking ADROVANCE and contact your doctor.

6)After swallowing your ADROVANCE tablet, wait at least 30 minutes before taking your first food, drink, or other medicine of the day, including antacids, calcium supplements and vitamins. ADROVANCE is effective only if taken when your stomach is empty.

If you take more ADROVANCE than you should

If you take too many tablets by mistake, drink a full glass of milk and contact your doctor immediately. Do not make yourself vomit, and do not lie down.

If you forget to take ADROVANCE

If you miss a dose, just take one tablet on the morning after you remember. Do not take two tablets on the same day. Return to taking one tablet once a week, as originally scheduled on your chosen day.

If you stop taking ADROVANCE

It is important that you take ADROVANCE for as long as your doctor prescribes the medicine. Since it is not known how long you should take ADROVANCE, you should discuss the need to stay on this medicine with your doctor periodically to determine if ADROVANCE is still right for you.

An Instruction Card is included in the carton for ADROVANCE. It contains important information reminding you how to take ADROVANCE properly.

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

4.Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

See your doctor immediately if you notice any of the following side effects, which may be serious, and for which you may need urgent medical treatment:

Common (may affect up to 1 in 10 people):

heartburn; difficulty swallowing; pain upon swallowing; ulceration of the gullet (oesophagus - the tube that connects your mouth with your stomach) which can cause chest pain, heartburn or difficulty or pain upon swallowing.

Rare (may affect up to 1 in 1,000 people):

allergic reactions such as hives; swelling of the face, lips, tongue and/or throat, possibly causing difficulty breathing or swallowing; severe skin reactions.

pain in the mouth, and/or jaw, swelling or sores inside the mouth, numbness or a feeling of heaviness in the jaw, or loosening of a tooth. These could be signs of bone damage in the jaw (osteonecrosis) generally associated with delayed healing and infection, often following tooth extraction. Contact your doctor and dentist if you experience such symptoms,

unusual fracture of the thigh bone particularly in patients on long-term treatment for osteoporosis may occur rarely. Contact your doctor if you experience pain, weakness or discomfort in your thigh, hip or groin as this may be an early indication of a possible fracture of the thigh bone,

bone, muscle and/or joint pain which is severe.

Other side effects include

Very common (may affect more than 1 in 10 people):

bone, muscle and/or joint pain which is sometimes severe.

Common (may affect up to 1 in 10 people):

joint swelling,

abdominal pain; uncomfortable feeling in the stomach or belching after eating; constipation; full or bloated feeling in the stomach; diarrhoea; flatulence,

hair loss; itching,

headache; dizziness,

tiredness; swelling in the hands or legs.

Uncommon (may affect up to 1 in 100 people):

nausea; vomiting,

irritation or inflammation of the gullet (oesophagus – the tube that connects your mouth with your stomach) or stomach,

black or tar-like stools,

blurred vision; pain or redness in the eye,

rash; redness of the skin,

transient flu-like symptoms, such as aching muscles, generally feeling unwell and sometimes with fever usually at the start of treatment,

taste disturbance.

Rare (may affect up to 1 in 1,000 people):

symptoms of low blood calcium levels including muscle cramps or spasms and/or tingling sensation in the fingers or around the mouth,

stomach or peptic ulcers (sometimes severe or with bleeding),

narrowing of the gullet (oesophagus – the tube that connects your mouth with your stomach),

rash made worse by sunlight,

mouth ulcers.

Very rare (may affect up to 1 in 10,000 people):

talk to your doctor if you have ear pain, discharge from the ear, and/or an ear infection. These could be signs of bone damage in the ear.

Reporting of side effects

If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet.

You can also report side effects directly via the national reporting system listed in Appendix V. By reporting side effects you can help provide more information on the safety of this medicine.

5.How to store ADROVANCE

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiry date which is stated on the carton and the blister after EXP. The expiry date refers to the last day of that month.

Store in the original blister in order to protect from moisture and light.

Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

6. Contents of the pack and other information

What ADROVANCE contains

The active substances are alendronic acid and colecalciferol (vitamin D3). Each ADROVANCE 70 mg/2,800 IU tablet contains 70 mg alendronic acid (as sodium trihydrate) and 70 micrograms (2,800 IU) colecalciferol (vitamin D3). Each ADROVANCE 70 mg/5,600 IU tablet contains 70 mg alendronic acid (as sodium trihydrate) and 140 micrograms (5,600 IU) colecalciferol (vitamin D3).

The other ingredients are microcrystalline cellulose (E460), lactose anhydrous (see section 2), medium chain triglycerides, gelatin, croscarmellose sodium, sucrose (see section 2), colloidal silicon dioxide, magnesium stearate (E572), butylhydroxytoluene (E321), modified starch (maize), and sodium aluminium silicate (E554).

What ADROVANCE looks like and contents of the pack

ADROVANCE 70 mg/2,800 IU tablets are available as modified capsule-shaped, white to off-white tablets marked with an outline of a bone image on one side and ‘710’ on the other. ADROVANCE 70 mg/2,800 IU tablets are available in packs containing 2, 4, 6 or 12 tablets.

ADROVANCE 70 mg/5,600 IU tablets are available as modified rectangle-shaped, white to off-white tablets marked with an outline of a bone image on one side and ‘270’ on the other. ADROVANCE 70 mg/5,600 IU tablets are available in packs containing 2, 4 or 12 tablets.

Not all pack sizes may be marketed.

Marketing Authorisation Holder

Merck Sharp & Dohme Limited

Hertford Road, Hoddesdon

Hertfordshire EN11 9BU

United Kingdom

Manufacturer

Merck Sharp & Dohme BV

Waarderweg 39

2031 BN, Haarlem

The Netherlands

For any information about this medicine, please contact the local representative of the Marketing Authorisation Holder.

Belgique/België/Belgien

Lietuva

MSD Belgium BVBA/SPRL

UAB Merck Sharp & Dohme

Tél/Tel: 0800 38 693 (+32 (0) 27766211)

Tel.: +370 5 278 02 47

dpoc_belux@merck.com

msd_lietuva@merck.com

България

Luxembourg/Luxemburg

Мерк Шарп и Доум България ЕООД

MSD Belgium BVBA/SPRL

Тел.: +359 2 819 3737

Tél/Tel: 0800 38 693 (+32 (0) 27766211)

info-msdbg@merck.com

dpoc_belux@merck.com

Česká republika

Magyarország

Merck Sharp & Dohme s.r.o.

MSD Pharma Hungary Kft.

Tel.: +420 233 010 111

Tel.: +36 1 888 53 00

dpoc_czechslovak@merck.com

hungary_msd@merck.com

Danmark

Malta

MSD Danmark ApS

Merck Sharp & Dohme Cyprus Limited

Tlf: +45 44824000

Tel: 8007 4433 (+356 99917558)

dkmail@merck.com

malta_info@merck.com

Deutschland

Nederland

MSD SHARP & DOHME GMBH

Merck Sharp & Dohme BV

Tel: 0800 673 673 673 (+49 (0) 89 4561 2612)

Tel: +31 (0)800 99 99 000 (+31 (0)23 5153153)

e-mail@msd.de

medicalinfo.nl@merck.com

Eesti

Norge

Merck Sharp & Dohme OÜ

MSD (Norge) AS

Tel.: +372 6144 200

Tlf: +47 32 20 73 00

msdeesti@merck.com

msdnorge@msd.no

Eλλάδα

Österreich

MSD Α.Φ.Β.Ε.Ε

Merck Sharp & Dohme Ges.m.b.H.

Τηλ: +30 210 98 97 300

Tel: +43 (0) 1 26 044

dpoc_greece@merck.com

msd-medizin@merck.com

España

Polska

Ferrer Internacional, S.A.

MSD Polska Sp.z o.o.

Tel: +34 93 600 37 00

Tel.: +48 22 549 51 00

medicaldep@ferrergrupo.com

msdpolska@merck.com

France

Portugal

IPSEN PHARMA

Merck Sharp & Dohme, Lda.

65 quai Georges Gorse

Tel: +351 214 465 700

92100 BOULOGNE-BILLANCOURT

clic@merck.com

Tél : +33 (0)1 58 33 50 00

 

Hrvatska

România

Merck Sharp & Dohme d.o.o.

Merck Sharp & Dohme Romania S.R.L.

Tel: + 385 1 6611 333

Tel: + 4021 529 29 00

croatia_info@merck.com

msdromania@merck.com

Ireland

Merck Sharp & Dohme Ireland (Human Health) Limited

Tel: +353 (0)1 2998700 medinfo_ireland@merck.com

Ísland

Vistor hf.

Sími: +354 535 7000

Ιtalia

Addenda Pharma S.r.l., Tel: +39-06-9139 3303

addendapharma@legalmail.it

Κύπρος

Merck Sharp & Dohme Cyprus Limited Τηλ: 80000 673 (+357 22866700) cyprus_info@merck.com

Latvija

SIA Merck Sharp & Dohme Latvija Tel: +371 67364 224 msd_lv@merck.com

This leaflet was last revised in

Slovenija

Merck Sharp & Dohme, inovativna zdravila d.o.o. Tel: + 386 1 5204201

msd_slovenia@merck.com

Slovenská republika

Merck Sharp & Dohme, s. r. o. Tel.: +421 2 58282010 dpoc_czechslovak@merck.com

Suomi/Finland

MSD Finland Oy

Puh/Tel: +358 (0) 9 804650 info@msd.fi

Sverige

Merck Sharp & Dohme (Sweden) AB Tel: +46 77 5700488 medicinskinfo@merck.com

United Kingdom

Merck Sharp & Dohme Limited Tel: +44 (0) 1992 467272 medicalinformationuk@merck.com

Detailed information on this medicine is available on the European Medicines Agency website: http://www.ema.europa.eu.

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