ALENDRONIC ACID WEEKLY TEVA-RATIO 70 mg TABLETS

2. What you need to know before you take Alendronic Acid Teva-ratio

Do not take Alendronic Acid Teva-ratio:

• if you are allergic to alendronic acid (alendronate sodium) or any of the other ingredients of this medicine (listed in section 6).
• if you have certain problems in your throat (esophagus - the tube that connects your mouth to your stomach) such as narrowing or difficulty swallowing
• if you cannot stand or sit up for at least 30 minutes
• if your doctor has told you that you have low blood calcium levels

If you think any of these apply to you, do not take the tablets. Talk to your doctor first and follow their advice.

Warnings and precautions

Talk to your doctor or pharmacist before starting this medicine if:

• you have kidney problems
• you have, or have recently had, stomach or swallowing problems
• your doctor has told you that you have Barrett's esophagus (a disease associated with changes in the cells that line the lower part of the esophagus)
• you have been told that you have problems absorbing minerals in your stomach or intestines (malabsorption syndrome)
• you have been told that you have low blood calcium levels
• you have poor dental hygiene, gum disease, a planned dental extraction, or do not receive regular dental care

• you have cancer
• you are undergoing chemotherapy or radiotherapy
• you are undergoing treatment with angiogenesis inhibitors (such as bevacizumab or thalidomide) used in the treatment of cancer
• you are taking corticosteroids (such as prednisone or dexamethasone) used to treat diseases such as asthma, rheumatoid arthritis, and severe allergies
• you are or have been a smoker (as this may increase the risk of dental problems).

You may be advised to have a dental check-up before starting treatment with this medicine.

It is important to maintain good oral hygiene when taking alendronate. You should have regular dental check-ups during your treatment and should contact your doctor or dentist if you experience any problems in your mouth or teeth, such as tooth loss, pain, or swelling.

Irritation, inflammation, or ulcers of the throat (esophagus - the tube that connects your mouth to your stomach) can occur, often with symptoms of chest pain, heartburn, difficulty or pain swallowing, especially if patients do not drink a full glass of water and/or if they lie down less than 30 minutes after taking the tablet. These side effects can worsen if patients continue taking the medicine after developing these symptoms.

Children and adolescents

This medicine must not be given to children and adolescents under 18 years of age.

Other medicines and Alendronic Acid Teva-ratio

Tell your doctor or pharmacist if you are using, have recently used, or might use any other medicines.

Calcium supplements, antacids, and other oral medicines may interfere with the absorption of alendronic acid, if taken at the same time. Therefore, it is important that you follow the advice given in section 3.

Certain medicines for rheumatism or long-term pain called NSAIDs (e.g., aspirin or ibuprofen) can cause stomach problems. Therefore, caution should be exercised if these medicines are taken at the same time as alendronate.

Taking Alendronic Acid Teva-ratio with food and drinks

Food and drinks (including mineral water) are likely to make Alendronic Acid Teva-ratio less effective if taken at the same time. Therefore, it is important that you follow the advice given in section 3.

Pregnancy and breastfeeding:

This medicine is only intended for use in postmenopausal women. Do not take Alendronic Acid if you are pregnant or think you may be pregnant, or during breastfeeding.

Ask your doctor or pharmacist for advice before taking any medicine.

Driving and using machines:

Side effects with this medicine (including blurred vision, dizziness, and severe bone, muscle, or joint pain) have been reported that may affect your ability to drive or use machines. Individual responses to the medicine may vary (see section 4).

3. How to take Alendronic Acid Teva-ratio

Follow exactly the instructions for administration of this medicine given by your doctor or pharmacist. In case of doubt, consult your doctor or pharmacist again.

Take one Alendronic Acid Teva-ratio tablet once a week.

1. Choose the day of the week that best suits your routine. Each week, take one tablet of the medicine on the day you have chosen

It is very important that you follow the instructions 2, 3, 4, and 5 to help the tablet reach the stomach quickly and reduce the possible irritation of the esophagus (the tube that connects your mouth to your stomach).

1. After getting up in the morning and before taking your first food, drink, or other medicine, swallow the tablet with a full glass of water (at least 200 ml).
   • do not take it with mineral water
   • do not take it with coffee or tea
   • do not take it with juice or milk.

Do not chew the alendronic acid tablet or let it dissolve in your mouth.

1. Do not lie down - stay upright (sitting, standing, or walking) - for at least 30 minutes after swallowing the tablet. Do not lie down until after your first food of the day.

1. Do not take this medicine at bedtime or before getting up in the morning.
2. If you have difficulty or pain swallowing, chest pain, or new or worsening heartburn, stop taking the medicine and inform your doctor.
3. After swallowing a tablet, wait at least 30 minutes before taking your first food, drink, or other medicine of the day, including antacids, calcium supplements, and vitamins. Alendronic acid is only effective if taken with an empty stomach.

If you take more Alendronic Acid Teva-ratio than you should:

If you take too many tablets by mistake, drink a full glass of milk and contact your doctor immediately. Do not induce vomiting and do not lie down.

In case of overdose or accidental ingestion, consult your doctor or pharmacist immediately or call the Toxicology Information Service, telephone (91) 562 04 20, indicating the medicine and the amount taken.

If you forget to take Alendronic Acid Teva-ratio:

If you miss a dose, wait until the next morning to take the medicine. Do not take two tablets on the same day.Then, take one tablet once a week, on the original day you chose.

If you stop taking Alendronic Acid Teva-ratio

It is important that you take the medicine for as long as your doctor has told you. As it is not known how long you should take this medicine, you should discuss with your doctor periodically whether you should continue treatment with this medicine to determine if alendronic acid is still suitable for you.

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

See your doctor immediatelyif you notice any of the following serious side effects, and for which you may need urgent medical treatment:

Common (may affect up to 1 in 10 people)

• Heartburn, difficulty swallowing, pain when swallowing; ulcers in the throat (esophagus - the tube that connects your mouth to your stomach), which can cause chest pain, heartburn, difficulty or pain swallowing.

Rare (may affect up to 1 in 1,000 people)

• allergic reactions such as hives; swelling of the face, lips, tongue, and/or throat, which can cause difficulty breathing or swallowing; severe skin reactions,
• pain in the mouth and/or jaw, swelling or ulcers inside the mouth, numbness or a feeling of heaviness in the jaw, or tooth loss. These can be signs of damage to the bone in the jaw (osteonecrosis) usually associated with delayed healing and infection, often after a tooth extraction. Inform your doctor and dentist if you experience these symptoms,
• atypical fractures of the thigh bone (femur) that can occur rarely, especially in patients on long-term treatment for osteoporosis. Inform your doctor if you notice pain, weakness, or discomfort in the thigh, hip, or groin, as these may be early signs of a possible fracture of the femur,
• severe pain in bones, muscles, and/or joints.

Frequency not known (cannot be estimated from the available data):

• atypical fracture in places other than the thigh bone (femur).

Other side effects include

Very common(may affect more than 1 in 10 patients)

• severe pain in bones, muscles, and/or joints.

Common(may affect up to 1 in 10 patients)

• joint swelling,
• abdominal pain, uncomfortable feeling in the stomach or belching after eating, constipation, diarrhea, difficulty swallowing, flatulence, feeling full or bloated stomach,
• hair loss; itching,
• headache, dizziness,
• fatigue, swelling of the hands or feet.

Uncommon(may affect up to 1 in 100 patients)

• nausea, vomiting,
• irritation or inflammation of the throat (esophagus - the tube that connects your mouth to your stomach) or stomach,

• black or tarry stools,
• blurred vision, eye pain or redness,
• skin rash, redness of the skin,
• transient symptoms similar to flu, such as muscle pain, general feeling of being unwell, and sometimes fever, which usually occur at the start of treatment,

• altered taste.

Rare(may affect up to 1 in 1,000 patients)

• symptoms of low blood calcium levels, including muscle cramps or spasms and/or tingling sensation in the fingers or around the mouth,
• stomach or duodenal ulcers (sometimes severe or with bleeding),
• narrowing of the throat (esophagus - the tube that connects your mouth to your stomach),
• skin rash that worsens with sunlight,
• mouth ulcers.

Very rare(may affect up to 1 in 10,000 people)

• consult your doctor if you have ear pain, discharge from the ear, or an ear infection. These could be symptoms of damage to the bones of the ear.

Reporting of side effects

If you experience any of these side effects, talk to your doctor or pharmacist, even if they are not listed in this leaflet. You can also report side effects directly to the Spanish Medicines Agency (AEMPS) at www.notificaRAM.es. By reporting side effects, you can help provide more information on the safety of this medicine.

5. Storage of Alendronic Acid Teva-ratio

Keep this medicine out of the sight and reach of children.

No special storage conditions are required.

Do not use this medicine after the expiry date which is stated on the carton after EXP. The expiry date is the last day of the month stated.

Medicines should not be disposed of via wastewater or household waste. Return any unused medicine to your pharmacist. Ask your pharmacist how to dispose of medicines no longer required. This will help protect the environment.

6. Contents of the pack and other information

Composition of Alendronic Acid Teva-ratio:

The active substance is alendronic acid. Each tablet contains 70 mg of alendronic acid as alendronate sodium trihydrate.

The other ingredients (excipients) are: Microcrystalline cellulose, crospovidone, and magnesium stearate.

Appearance of the product and pack contents

Alendronic Acid Teva-ratiois presented in the form of tablets. The tablets are white, oval, and flat, marked on one side with “70”.

Each pack contains 4 tablets packaged in an aluminum/aluminum blister pack.

Marketing authorization holder:

Teva Pharma, S.L.U.

Anabel Segura 11, Edificio Albatros B, 1st floor,

Alcobendas, 28108 Madrid (Spain)

Manufacturer:

Teva Pharma, S.L.U.

Malpica polygon, C/ C 4.

50016 - Zaragoza.

Date of last revision of this leaflet: November 2024

Detailed and up-to-date information on this medicine is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) http://www.aemps.gob.es/

You can access detailed and up-to-date information about this medicine by scanning the QR code included in the packaging with your smartphone. You can also access this information at the following internet address: https://cima.aemps.es/cima/dochtml/p/68841/P_68841.html