Which of the following active ingredients found in Fosamax Plus D?
 
a. Vitamin D1
b. Vitamin D2
c. Vitamin D3
d. Vitamin D4
e. Vitamin D5

Answer: (c) Alendronate sodium is a bisphosphonate that acts as a specific inhibitor of osteoclast mediated bone resorption. Bisphosphonates are synthetic analogs of pyrophosphate that bind to the hydroxyapatite found in bone.
 
Fosamax Plus D contains Alendronate sodium, a bisphosphonate, and Cholecalciferol (vitamin D3). Cholecalciferol (vitamin D3) is a secosterol that is the natural precursor of the calcium-regulating hormone calcitriol (1,25 dihydroxyvitamin D3).
 
It is indicated for the treatment of osteoporosis in postmenopausal women and to increase bone mass in men with osteoporosis.
 
The recommended dosage is one 70 mg Alendronate/2800 international units vitamin D3 or one 70 mg Alendronate/5600 international units vitamin D3 tablet once weekly.

Important Administration Instructions:

1. Take the drug at least one-half hour before the first food, beverage, or medication of the day with plain water only. Other beverages (including mineral water), food, and some medications are likely to reduce the absorption of Alendronate. Waiting less than 30 minutes, or taking Fosamax Plus D with food, beverages (other than plain water) or other medications will lessen the effect of Alendronate by decreasing its absorption into the body.

2. Take Fosamax Plus D upon arising for the day. To facilitate delivery to the stomach and thus reduce the potential for esophageal irritation, a Fosamax Plus D tablet should be swallowed with a full glass of water (6-8 ounces).

3. Patients should not lie down for at least 30 minutes and until after their first food of the day.

4. Fosamax Plus D should not be taken at bedtime or before arising for the day. Failure to follow these instructions may increase the risk of esophageal adverse experiences. 
 
Asthenia, diarrhea, abdominal pain, edema, leg cramps and rash are commonly reported side effects of Fosamax Plus D.

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