Drug Interaction:
Food, milk and derivative products, and medicinal products containg calciummay reduce
the bioavailability of strontium ranelate by approximately 60-70% ,.
Therefore admin of strontium ranelate and such products should be separated by at least two hours
It is advisable to take antacids at least two hours after strontium ranelate
In vivo interaction study has shown that administration of Aluminium and Magnesium Hydroxide two hours before or together with Strontium ranelate cause a a slight decrease in the absorption of strontium ranealate ( 20-25% decrease in AUC)
It is therfore preferable to not administer them concurently, however if this is impractical
concomittant intake is acceptable.
As divalent cations such as strontium ranelate can form complexes with oral tetracycline
and quinolons antibiotics and reduce their absorption.
Simultaneous administration of strontium ranelate with these medicinal products is not
recommended. As a precautionay measure treatment with strontium ranelate should be
suspended during treatment with these drugs.
Stronitium does nort inhibit cytochrome P450 enzymes.
No interactions with oral vitamin D ,NSAIDs ,paracetamoil, H2 blockers, proton pump
inhibitors, .Angiotensin II antagonists, betablockers,oral anticoagulants, statins, fibrates
and benzodizepines were found during clinical trials.
Adverse Reaction:
Most common adverse reactions are- nausea and diarrheoa, which were gernerally reported at the beginning of the treatment ( in clinical trials) with no noticebale differences between groups afterwards.
Other adverse efects include headache, loose stools, and ezcema. Phase III studies showed that compared to palcebo strontium ranelate showed an increased annual incidence of venous thromboembolism
Dosages/ Overdosage Etc:
Post menopausal osteoporosis
Recommended dose is one g sachet once daily by oral administration Goood tolerance shown in clinical studyinvoving repeted admin of 4g of stronitiumranelate per day for 25 days in healthy post menopausal women.
Single admin upto 11g in healthy young males did not show any particular symptoms. In the event of substantial overdosage vomiting may be considered to remove unabsoebed active substance.
To reduce absorption of active substance admin of milk or antacids may be helpful.
Pharmacology/ Pharmacokinetics:
Pharmacology- In vitro studies show that strontium ranelate increases bone marrow formation in bone tissue cuture as well as osteoblast percursor replication and collagen synthesis in bone marrow culture. It also reduces bone marrow resorption by decreasing osteoclast differentiation and restoring activity. This results in a rebalance of bone marrow turnover in favour of bone formation
Pharmacokinetics- The absolute bioavailability of strontium ranelate is about 25% after an oral dose of 2g strontium ranelate. Maximum plasma concentrations are reduced 3-5 hours after a single dose. Steady state is reached after 2 weeks of treatment. Elimination of strontium ranelate is dose dependent
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