Alendronate Is Safe with NSAIDs

Oral bisphosphonates such as alendronate and nonsteroidalanti-inflammatory drugs (NSAIDs) can irritate theupper gastrointestinal (GI) tract and damage the intestinalmucosa. Frequently, the same patient population concomitantlyuses both types of treatment. B. Cryer, MD, and colleaguesaddressed the concern over potential additive effects and thelikelihood of damage in patients taking concomitant NSAIDsand alendronate (70 mg/wk) in a 12-week, double-blind, placebo-controlled study of 450 patients. The results of the study,reported in Alimentary Pharmacology and Therapeutics(March 2005), showed no significant difference in upper GIadverse events (AEs) among NSAID users receiving concomitantalendronate (n = 118) or placebo (n = 104).

Similarly, no significant differences in AEs were notedbetween those who were and those who were not also taking agastroprotective agent (eg, a proton pump inhibitor or a histamine² antagonist). In addition, there was no significant differencein upper GI AEs in patients taking a cyclooxygenase-2-specific NSAID, compared with a nonspecific NSAID. Theauthors concluded that there is no increase in upper GI AEswith concomitant use of once-weekly alendronate and NSAIDs.