{ "schema_version": 1, "kind": "condition", "id": "osteoporosis", "name": "Osteoporosis (postmenopausal & senile)", "category": "chronic", "sources": "NOGG Osteoporosis Guideline 2021 for the treatment threshold, with the dose from Alendronic Acid 70 mg tablets SmPC section 4.2 (eMC product 5206): \"The recommended dosage is one 70 mg tablet once weekly.\" and \"Alendronic Acid should only be swallowed upon arising for the day with a full glass of water (not less than 200 ml). ... Patients should not lie down for at least 30 minutes after taking Alendronic Acid and until after the first food of the day.\" · NOGG Osteoporosis Guideline 2021 · Egyptian National Drug Formulary - Endocrine System 2024 · Risedronate sodium 35 mg film-coated tablets SmPC sections 4.2 and 4.4 (eMC product 3028)", "review_status": "reviewed", "verified_against": "NOGG Osteoporosis Guideline 2021 for the treatment threshold, with the dose from Alendronic Acid 70 mg tablets SmPC section 4.2 (eMC product 5206): \"The recommended dosage is one 70 mg tablet once weekly.\" and \"Alendronic Acid should only be swallowed upon arising for the day with a full glass of water (not less than 200 ml). ... Patients should not lie down for at least 30 minutes after taking Alendronic Acid and until after the first food of the day.\" · NOGG Osteoporosis Guideline 2021 · Risedronate sodium 35 mg film-coated tablets SmPC sections 4.2 and 4.4 (eMC product 3028)", "verified_date": "2026-08", "treatments": [ { "id": 1273, "generic": "Alendronate", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 70.0, "adult_dose": "70 mg once weekly swallowed whole with a full glass of plain water on empty stomach upon arising; remain upright for at least 30 minutes", "adult_duration": "long-term (5 years, then review)", "dose_source": "NOGG Osteoporosis Guideline 2021 for the treatment threshold, with the dose from Alendronic Acid 70 mg tablets SmPC section 4.2 (eMC product 5206): \"The recommended dosage is one 70 mg tablet once weekly.\" and \"Alendronic Acid should only be swallowed upon arising for the day with a full glass of water (not less than 200 ml). ... Patients should not lie down for at least 30 minutes after taking Alendronic Acid and until after the first food of the day.\"", "rationale": "Alendronate is a bisphosphonate that binds bone mineral and inhibits osteoclast-mediated bone resorption, slowing bone loss and increasing bone density; it is standard first-line therapy for postmenopausal and senile osteoporosis per NOGG.", "cautions": [ "STRICT ADMINISTRATION INSTRUCTIONS: Take with plain water only on an empty stomach and stay upright for 30 minutes (severe esophageal ulceration risk if violated).", "Contraindicated in esophageal abnormalities, inability to sit/stand upright for 30 minutes, or hypocalcemia.", "Contraindicated if eGFR < 35 mL/min.", "Atypical femoral fractures and osteonecrosis of the jaw are rare long-term risks; arrange dental exam prior to starting." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Specialist pediatric metabolic bone clinic use only", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "ALENDEX 70MG 2 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UNIPHARMA CO. > UNIPHARMA", "price_egp": 17.4, "pack_count": 2, "unit_price": 8.7, "strength_mg": 70.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "OSTEONATE 70MG 4 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ADWIA", "price_egp": 40.0, "pack_count": 4, "unit_price": 10.0, "strength_mg": 70.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BONALENE 70MG 2 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL-OBOUR", "price_egp": 21.6, "pack_count": 2, "unit_price": 10.8, "strength_mg": 70.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ALENDENE 70MG 2 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ATOS PHARMA", "price_egp": 35.0, "pack_count": 2, "unit_price": 17.5, "strength_mg": 70.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ALENDOMAX 70 MG 2 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA", "price_egp": 35.0, "pack_count": 2, "unit_price": 17.5, "strength_mg": 70.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "OSTEOMEPHA 70MG 2 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA > ACINO", "price_egp": 35.0, "pack_count": 2, "unit_price": 17.5, "strength_mg": 70.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FOSAMAX ONCE WEEKLY 70MG 2 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MERCK SHARP & DOHME > GLOBAL NAPI PHARMACEUTICALS", "price_egp": 62.75, "pack_count": 2, "unit_price": 31.38, "strength_mg": 70.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "osteoporosis" }, { "id": 1274, "generic": "Risedronate sodium", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 35.0, "adult_dose": "35 mg once weekly swallowed whole with plain water on empty stomach 30 minutes before first food/drink; remain upright for 30 minutes", "adult_duration": "long-term (5 years)", "dose_source": "Risedronate sodium 35 mg film-coated tablets SmPC sections 4.2 and 4.4 (eMC product 3028)", "rationale": "Alternative oral bisphosphonate with lower incidence of upper GI intolerance", "cautions": [ "Risedronate sodium has the same strict upper GI administration precautions as alendronate.", "Contraindicated if eGFR < 30 mL/min or hypocalcemia present.", "Correct hypocalcemia and vitamin D deficiency before initiating bisphosphonate therapy.", "A full glass of plain water, at least 120 mL, and stay upright for 30 minutes afterwards. Lying down is how the tablet lodges and burns the oesophagus.", "Contraindicated below a creatinine clearance of 30 mL/min.", "Correct low calcium before starting, not during.", "Arrange a dental check first where there are other risk factors - osteonecrosis of the jaw is the reason.", "Tell the patient that painful or difficult swallowing, chest pain behind the sternum, or new heartburn means come back, not push through." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Not indicated in children", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "ACTOWEEK 35 MG 1 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CHEMIPHARM", "price_egp": 20.0, "pack_count": 1, "unit_price": 20.0, "strength_mg": 35.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "RISALDENE 35MG 2 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "HIKMA PHARMA", "price_egp": 40.0, "pack_count": 2, "unit_price": 20.0, "strength_mg": 35.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "osteoporosis" }, { "id": 1275, "generic": "Calcium carbonate", "line": 1, "is_adjunct": true, "form": "oral.solid", "strength_mg": 500.0, "adult_dose": "500-1000 mg elemental calcium daily combined with Vitamin D3 (Cholecalciferol) 800-1000 IU daily", "adult_duration": "long-term", "dose_source": "NOGG Osteoporosis Guideline 2021", "rationale": "Essential co-prescription with bisphosphonates to maintain bone mineral density and prevent hypocalcemia", "cautions": [ "Separate calcium supplements from bisphosphonates by at least 2 hours (calcium inhibits bisphosphonate absorption).", "Constipation and flatulence are common.", "Avoid in hypercalcemia or hypercalciuria." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Pediatric calcium requirements vary by age", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "OSCASEEF 500MG 30 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SAFE PHARMA", "price_egp": 21.75, "pack_count": 30, "unit_price": 0.72, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CALCIMATE 500 MG 12 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NASR", "price_egp": 20.0, "pack_count": 12, "unit_price": 1.67, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CARIBO 500MG 50 CHEW. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AL ESRAA PHARMACEUTICAL OPTIMA", "price_egp": 18.0, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CALCINEX PLUS SYRUP 120 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "FAMILY PHARMACIA > SPHINX PHARMA", "price_egp": 59.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "osteoporosis" } ] }