Bisphosphonate + calcium/vitamin D
Risedronate with calcium carbonate and colecalciferol
Brand names: Actonel Combi
Adult dose
Dose: Risedronate 35mg once weekly + calcium 1g/colecalciferol 880 IU on remaining 6 days
Route: PO
Frequency: weekly + daily
Clinical pearls
- Postmenopausal osteoporosis
- Risedronate dose: empty stomach with water, sit upright 30 min
Contraindications
- Pregnancy/breastfeeding
- Hypocalcaemia
- Severe renal impairment
- Inability to sit/stand upright 30 min
- Oesophageal abnormalities
- Hypercalcaemia
Side effects
- Oesophagitis
- Hypocalcaemia
- Osteonecrosis of jaw
- Atypical femoral fracture
- GI upset
- Constipation (calcium)
Interactions
- Antacids/iron/calcium (separate from risedronate by ≥30 min)
- PPIs
- Tetracyclines
Monitoring
- BMD
- Calcium
- Vitamin D
Reference: BNF; NICE TA464; https://bnf.nice.org.uk/drugs/risedronate-with-calcium-carbonate-and-colecalciferol/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- Hyperkalaemia Management Algorithm · Electrolyte Disorders
- FAST Exam Protocol — Focused Assessment with Sonography in Trauma · Trauma
- CAROC System — Fracture Risk Assessment · Osteoporosis
- FRAX Score (Fracture Risk Assessment) · Osteoporosis
- Corrected Calcium · Electrolytes
- Calcium-Phosphate Product · Electrolytes
Pathways
- Diabetic Ketoacidosis (DKA) · JBDS 2013 / Joint British Diabetes Societies; NICE NG17
- Adult Hypoglycaemia (Treated Diabetes) · JBDS-IP (2023): Hospital Management of Hypoglycaemia
- Adrenal Crisis · Society for Endocrinology Emergency Guidance (2024)
- Type 2 Diabetes Management · NICE NG28 2022
- Hyperthyroidism Management · BTA / ETA 2018
- Adrenal Insufficiency · Society of Endocrinology / ESE 2016