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This medication comes with several important safety warnings and contraindications that you should carefully consider. Please review the information below and discuss any concerns with your healthcare provider.

• Stomach and Esophagus Irritation and Ulcers: Taking risedronate (Actonel) may cause irritation or ulcers in the stomach and esophagus, leading to symptoms like heartburn and pain. To minimize these risks, take the medication with a full glass of water while standing or sitting upright, and remain upright for at least 30 minutes afterward. Discontinue use and contact your healthcare provider if you experience difficulty swallowing, new or worsening heartburn, or pain around the chest. Individuals with a history of ulcers, digestive problems, or those taking NSAIDs or aspirin are at increased risk.

• Jawbone Breakdown (Osteonecrosis): Although rare, risedronate (Actonel) can lead to jawbone weakening, especially after dental procedures or infections. To reduce risk, maintain good oral hygiene and inform your dentist about your medication use. Complete necessary dental work before starting risedronate (Actonel). Consult a doctor if you experience jaw pain or swelling. Higher risk is associated with dental issues, anemia, bleeding problems, cancer, concurrent cancer medication use, and prolonged risedronate (Actonel) therapy.

• Severe Bone, Joint, or Muscle Pain: Some individuals may experience severe pain in bones, joints, or muscles, which can occur shortly after beginning treatment. If severe pain arises, consult your healthcare provider as discontinuation may be necessary.

• Leg Bone Fractures: Rarely, unexplained leg fractures may occur. If you notice new, dull, or aching pain in the hips or thighs, contact your healthcare provider immediately. This risk is heightened for those taking corticosteroids.

• Low Calcium in the Blood: Risedronate (Actonel) can reduce blood calcium levels, which must be corrected before starting treatment. Calcium and vitamin D supplements may be recommended to maintain levels. Symptoms of low calcium include muscle spasms, twitching, or numbness and tingling in extremities. Discuss any such symptoms with your healthcare provider.

Contraindications:

• Esophagus issues
• Inability to remain upright for at least 30 minutes post-dose
• Low blood calcium levels

If any of these contraindications apply to you, consult your healthcare provider before using this medication.

Common side effects:

• infections
• back pain
• joint pain
• constipation
• stomach pain
• heartburn
• nausea
• diarrhea
• flu-like symptoms
• urinary tract infections
• arthritis
• headaches
• bronchitis

Less common but important to monitor:

• muscle pain
• neck pain
• chest pain
• bone pain
• bone fractures
• weakness in the arms or legs
• swelling
• dizziness
• runny nose
• sore throat
• sinus infections
• trouble sleeping
• depression

Serious side effects:

• increased or severe bone, joint, or muscle pain
• new or unusual hip, thigh, or groin pain
• jaw pain
• eye or vision problems
• irritation or ulcers in the stomach or esophagus
• severe heartburn
• chest pain
• difficult swallowing
• severe stomach pain
• black/tarry stools
• vomit resembling coffee grounds
• very serious allergic reaction
• rash
• itching or swelling of the face, tongue, or throat
• severe dizziness
• trouble breathing

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Esomeprazole