Optimal Dosing Regimen of Osteoporosis Drugs in Relation to Food Intake as the Key for the Enhancement of the Treatment Effectiveness-A Concise Literature Review.
Agnieszka WiesnerMariusz SzutaAgnieszka GalantyPaweł PaśkoPublished in: Foods (Basel, Switzerland) (2021)
Bisphosphonates and selective estrogen receptor modulators (SERMs) represent the two most important groups of medications taken orally and employed in osteoporosis treatment. Effectiveness of the therapy may be affected by poor patient adherence, in particular, due to the inconvenient dosing regimen of oral bisphosphonates. With this review we aimed to assess the effects that food, beverages, and dietary supplements consumed during treatment, along with the dosing regimens, may have on pharmacokinetics and pharmacodynamics of oral drugs employed in treating osteoporosis; we also aimed to shape the recommendations valuable for professional patients' counseling and education, to provide appropriate dosing regimens in order to improve adherence to the therapy. Food, beverages such as coffee, juices, and mineral water, as well as dietary supplements containing multivalent cations, e.g., calcium, magnesium, aluminium, iron, showed to have a deleterious effect on the bioavailability of all the investigated oral bisphosphonates, specifically alendronate, risedronate, ibandronate, minodronate, and etidronate. For risedronate, a delayed-release (DR) tablet was designed to solve the malabsorption problem in the presence of food, hence DR risedronate can be ingested following breakfast. For other oral bisphosphonates, the proper interval between drug and food, beverages, and dietary supplements intake should be maintained to minimize the risk of interactions. The effect of food on pharmacokinetic parameters of selective estrogen receptor modulators (SERMs) was found to be clinically irrelevant.
Keyphrases
- estrogen receptor
- postmenopausal women
- human health
- randomized controlled trial
- end stage renal disease
- small molecule
- systematic review
- bone mineral density
- healthcare
- chronic kidney disease
- case report
- ejection fraction
- risk assessment
- type diabetes
- emergency department
- body mass index
- insulin resistance
- clinical practice
- prognostic factors
- mass spectrometry
- metabolic syndrome
- weight loss
- replacement therapy
- hepatitis c virus
- ionic liquid
- peritoneal dialysis
- physical activity
- cell therapy
- iron deficiency