Actonel Warnings and Precautions

Before starting a new medication, it is important to understand the risks involved. With Actonel, warnings and precautions include being aware that the drug can damage the stomach, cause extreme muscle pain, and interact with certain medications. To help ensure a safe and successful treatment, make sure to talk to your healthcare provider about the specific Actonel warnings and precautions that apply to you.

Actonel: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking Actonel® (risedronate sodium) if you have:
  • Low blood calcium (hypocalcemia)
  • An inability to sit upright or stand for 30 minutes
  • Kidney disease, including kidney failure (renal failure)
  • Difficulty swallowing or other problems with your esophagus
  • Any allergies, including allergies to food, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding
  • Planning to have a dental procedure.
Make sure to tell your healthcare provider about all medicines you may be taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Specific Actonel Warnings and Precautions

Warnings and precautions to be aware of prior to taking Actonel include the following:
  • In rare cases, bisphosphonates (including Actonel) have caused a condition called osteonecrosis of the jaw. This is a serious, possibly disfiguring, problem in which the bone of the jaw dies. Often, there are symptoms (such as pain, infection, or loosening of the teeth), but sometimes there are no symptoms until a person notices exposed bone. This problem is most common when bisphosphonates are given by IV, but is still possible when these medications are taken orally. It seems that people who have dental procedures such as a tooth extraction are also at higher risk. Be sure to take good care of your mouth and teeth by seeing your dentist frequently. Let your healthcare provider know right away if you think you may have osteonecrosis of the jaw.


  • There have been rare reports of unusual broken thigh bones in people taking bisphosphonate medications like Actonel. It is not yet clear if the medications are to blame, since the fractures could simply be due to osteoporosis or other factors. These fractures typically were not caused by trauma or injury. Let your healthcare provider know if you have unexplained groin or thigh pain, as these are sometimes signs of thigh fractures. 


  • Actonel, like all bisphosphonate medications, can irritate or damage the esophagus and stomach. This can lead to indigestion, heartburn, or even ulcers. Let your healthcare provider know if you notice any of these problems while taking the drug.
  • It is important to closely follow the instructions for taking Actonel. Not doing so could increase your risk of side effects or may make Actonel ineffective (see Actonel Dosage for more information).
  • It is important that you get enough calcium and vitamin D while taking Actonel, either through your diet or by supplementation. Calcium and vitamin D are necessary for rebuilding bone and preventing further bone loss. Actonel cannot work if you do not get enough of these substances.
  • Actonel may not be recommended for people with severe kidney disease.
  • Bisphosphonates (including Actonel) can cause extreme muscle or bone pain. This usually goes away once the medication is stopped.
  • Actonel can potentially interact with a number of medications (see Actonel Drug Interactions).
  • Actonel is considered a pregnancy Category C medication. This means that it may not be safe for use during pregnancy (see Actonel and Pregnancy).
  • It is not known whether Actonel passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Actonel and Breastfeeding).
Exercises for Strong Bones

Actonel for Osteoporosis

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