Overview
Risedronate is a bisphosphonate used for the prevention and treatment of osteoporosis and Paget’s disease of bone. It helps to strengthen bones, increase bone mineral density, and significantly reduce the risk of fractures by inhibiting the cells that break down bone tissue.

Mechanism of Action
Like other bisphosphonates, risedronate binds to bone hydroxyapatite and inhibits osteoclast-mediated bone resorption. By slowing down the rate at which bone is dissolved, it allows bone-building cells (osteoblasts) to work more effectively, resulting in an increase in bone mass and a restoration of bone strength.

Dosage and Administration
For osteoporosis, it is available in various dosing regimens, including 5 mg daily, 35 mg once weekly, or 150 mg once a month. Similar to alendronate, it must be taken first thing in the morning on an empty stomach with a full glass of plain water, at least 30 minutes before the first food or drink. Patients must remain upright for at least 30 minutes after dosing.

Side Effects
Gastrointestinal side effects are the most common, including upset stomach, indigestion, and potential esophageal irritation. Musculoskeletal pain (bone, muscle, or joint pain) can also occur. Rare risks include osteonecrosis of the jaw and atypical femur fractures with prolonged therapy.

Contraindications
It is contraindicated in patients with esophageal abnormalities that delay emptying, inability to stand or sit upright for at least 30 minutes, hypocalcemia, or known hypersensitivity to risedronate.

Pregnancy and Lactation
It should be used during pregnancy only if the potential benefit justifies the potential risk to the mother and fetus. It is not known whether risedronate is excreted in human milk.