It's OK to take fosamax with other meds?

[Blackcat99]

I was told that a resident who takes fosamax or similiar meds should not eat or take other pills at the same time. Therefore, I have told the med aides to not give fosamax at the same time as the other pills. So they went to my boss and asked her and she said Yes, it's OK to give fosamax and other meds at the same exact time. What to do?

[pagandeva2000, LPN]

Do you have this information in a reputable source to show the nursing supervisor? Like maybe a drug guide, or PDA? It may be better to show something in writing to state your case better. This is nice to know, by the way, because I wasn't aware of this myself. I'll check my drugbook later for clarity.

[TakeTwoAspirin, MSN, RN, APRN]

My PDA:

"PO: Administer first thing in the morning with 6-8 oz plain water 30 minutes before other medications, beverages, or food."

[Tait, MSN, RN]

I talked to a pharmacist about this. It isn't life threatening, however other medications/foods interfere with the absorption of the med. Thus less bang for your buck.

[hypocaffeinemia, BSN, RN]

My two resources on my PDA (Thompson micromedex and PEPID) say the same thing: take with a full glass of water at least 30 minutes before other medications.

[Blackcat99]

Thanks all. Yes, I'll get some written medical info to show to her.

[NRSKarenRN, BSN, RN]

good for you being a patient advocate:

print out the precautions, discuss with your pharmacy consultant and bring up at pts care conference :

:typing

how should this medicine be used?

alendronate comes as a tablet and a solution (liquid) to take by mouth. the solution is usually taken on an empty stomach once a week in the morning. the 5-mg and 10-mg tablets are usually taken on an empty stomach once a day in the morning, and the 35-mg and 70-mg tablets are usually taken on an empty stomach once a week in the morning. the 40-mg tablets are usually taken once a day in the morning for six months to treat paget's disease of bone. follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. take alendronate exactly as directed. do not take more or less of it or take it more often than prescribed by your doctor.

alendronate may not work properly and may damage the esophagus (tube between the mouth and stomach) or cause sores in the mouth if it is not taken according to the following instructions. tell your doctor if you do not understand, you do not think you will remember, or you are unable to follow these instructions:

• you must take alendronate just after you get out of bed in the morning, before you eat or drink anything. never take alendronate at bedtime or before you wake up and get out of bed for the day.
  
• swallow alendronate tablets with a full glass (6-8 ounces or 180-240 ml) of plain water. drink at least a quarter of a cup (2 ounces or 60 ml) of plain water after you take alendronate solution. never take alendronate tablets or solution with tea, coffee, juice, milk, mineral water, sparkling water, or any liquid other than plain water.
  
• swallow the tablets whole; do not split, chew or crush them. do not suck on the tablets.
  
• after you take alendronate, do not eat, drink, or take any other medications (including vitamins or antacids) for at least 30 minutes. do not lie down for at least 30 minutes after you take alendronate. sit upright or stand upright until at least 30 minutes have passed and you have eaten your first food of the day.

http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a601011.html

fosamax

if these precautions not followed, esophagel or mouth ulcers will occur and can progress to esophageal erosion resulting in aspiration pneumonia and necrosis of mouth/esophagus.

fosamax consequences - drug complications results in numerous lawsuits

nursing's goal always: prevent patient harm

facility would be held responsible if found med not administered properly..... and we wouldn't want that that to happen.

[Blackcat99]

Thanks NRSKarenRN. :DI made a copy of your post and will give copies to the med aides and to the boss.

[pagandeva2000, LPN]

Ah, yes, I forgot all about how to take it well before any meals and especially to sit up for at least 30 minutes after the fact. They made a big deal of making us remember this during my review course for NCLEX. Where is my head??? Anyways, yes, take this to your leader!

[pagandeva2000, LPN]

I also appreciate the information from NRSKarenRN and Blackcat99 for initiating this thread. Sometimes, we remember things when it is brought up in real life situations, like these forums to jog the memory. Thanks!