Delayed Gastrointestinal Complications Associated with Alendronate: a Case Involving an Elderly Nursing Home Resident
Alendronate (Fosamax®) is an amino-bisphosphonate that binds to bone hydroxyapatite and inhibits osteoclast activity in bone resorption.1 It is indicated for the treatment of Paget’s disease, as well as for the prevention and treatment of osteoporosis in postmenopausal women. Alendronate can cause local irritation of the upper gastrointestinal mucosa leading to esophagitis, esophageal ulcers, and erosion. The product monograph2 provides direction on proper administration to lessen the risk of esophageal injury. However, even when these directions are followed, esophageal injury is possible. This report describes a case of probable upper gastrointestinal damage in a very elderly patient who had been taking alendronate for more than 1 year.
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