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What is the most important information I should know about Actonel?
• Although it has been reported less frequently with Actonel, other similardrugs can be very damaging to the mouth and stomach pictures and images of osteoporosis. Do not lie down for atleast 30 minutes after taking a dose of Actonel pictures and images of osteoporosis.
• Take Actonel in the morning with a full glass (6 to 8 ounces) of tapwater or bottled water at least 30 minutes before eating any food, drinkingany liquid (other than water), or taking any other medicines including vitamins,minerals, or other supplements pictures and images of osteoporosis. Do not take Actonel with mineral water, juice,or any other beverage since these beverages may decrease the effectiveness ofthe medication pictures and images of osteoporosis. This timing is very important in getting the maximum amountof medication from each dose pictures and images of osteoporosis. Foods, beverages, and other medications greatlydecrease the effect of Actonel pictures and images of osteoporosis.
• The 35 mg Actonel tablets should only be taken once a week, preferablyon the same day each week pictures and images of osteoporosis. Follow your doctor's instructions pictures and images of osteoporosis.

What is Actonel?
• Actonel alters the cycle of bone formation and breakdown in the body pictures and images of osteoporosis.
• Actonel is used to prevent and treat postmenopausal and steroid-causedbone-thinning (osteoporosis) pictures and images of osteoporosis. Actonel is also used to treat Paget's diseaseof bone (osteitis deformans) pictures and images of osteoporosis.
• Actonel may also be used for purposes other than those listed in thismedication guide pictures and images of osteoporosis.

What should I discuss with my healthcare provider before taking Actonel?
• Do not take Actonel without first talking to your doctor if you
· have a problem swallowing, such as a narrowing of the esophagus;
· have esophageal ulcers or esophageal disease;
· have stomach ulcers or other stomach problems;
· have a condition that causes low levels of calcium in the body;
· have a kidney disease; or
· are unable to stand or sit upright for at least 30 minutes pictures and images of osteoporosis.
• You may not be able to take Actonel, or you may require a dosage adjustmentor special monitoring during treatment if you have any of the conditions listedabove pictures and images of osteoporosis.
• Actonel is in the FDA pregnancy category C pictures and images of osteoporosis. This means that it is notknown whether it will be harmful to an unborn baby pictures and images of osteoporosis. Do not take Actonel withoutfirst talking to your doctor if you are pregnant or could become pregnant duringtreatment pictures and images of osteoporosis.
• It is not known whether Actonel passes into breast milk pictures and images of osteoporosis. Do not takeActonel without first talking to your doctor if you are breast-feeding a baby pictures and images of osteoporosis.

How should I take Actonel?
• Take Actonel exactly as directed by your doctor pictures and images of osteoporosis. If you do not understandthese directions, ask your pharmacist, nurse, or doctor to explain them to you pictures and images of osteoporosis.
• Take Actonel in the morning with a full glass (6 to 8 ounces) of tapwater or bottled water at least 30 minutes before eating any food, drinkingany liquid (other than water), or taking any other medicines including vitamins,minerals, or other supplements pictures and images of osteoporosis. Do not take Actonel with mineral water, juice,or any other beverage since these beverages may decrease the effectiveness ofthe medication pictures and images of osteoporosis. This timing is very important in getting the maximum amountof medication from each dose pictures and images of osteoporosis. Foods, beverages, and other medications greatlydecrease the effect of Actonel pictures and images of osteoporosis.
• Although it has been reported less frequently with Actonel, other similardrugs can be very damaging to the mouth and stomach pictures and images of osteoporosis. Do not lie down for atleast 30 minutes after taking a dose of Actonel pictures and images of osteoporosis.
• Do not crush, chew, or suck the pills pictures and images of osteoporosis. Swallow them whole pictures and images of osteoporosis.
• The 35 mg Actonel tablets should only be taken once a week, preferablyon the same day each week pictures and images of osteoporosis. Follow your doctor's instructions pictures and images of osteoporosis.
• It is important to maintain adequate amounts of calcium and vitamin Din the diet while taking Actonel pictures and images of osteoporosis. Discuss with your doctor appropriate amountsof calcium and vitamin D pictures and images of osteoporosis.
• Store Actonel at room temperature away from moisture and heat pictures and images of osteoporosis.

What happens if I miss a dose?
• If you take Actonel every day and you miss a dose, skip that dose andtake the next regularly scheduled dose the following day pictures and images of osteoporosis. Missing one dose willnot make a difference in the treatment pictures and images of osteoporosis.
• If you take Actonel once a week and you miss a dose, take the misseddose the next morning pictures and images of osteoporosis. Do not take two tablets on the same day pictures and images of osteoporosis. Then, returnto your regular schedule, taking one tablet on the chosen morning of the week pictures and images of osteoporosis.

What happens if I overdose?
• Seek emergency medical attention pictures and images of osteoporosis.
• The symptoms of a Actonel overdose are unknown, but the following symptomsmight be expected: nausea, heartburn, pain in the abdomen, diarrhea, other stomach-relatedsymptoms, muscle cramps, numbness or tingling, uncontrollable facial grimacing,seizures, irritability, and abnormal behavior pictures and images of osteoporosis.

What should I avoid while taking Actonel?
• There are no restrictions on food, beverages, or activity while takingActonel, unless otherwise directed by your doctor pictures and images of osteoporosis.

What are the possible side effects of Actonel?
• Stop taking Actonel and seek emergency medical attention or contact yourdoctor immediately if you experience any of the following serious side effects:
· an allergic reaction (difficulty breathing; closing of the throat;swelling of the lips, tongue, or face; or hives);
· difficulty or pain when swallowing;
· pain or burning under the ribs or in the back; or
· new or worsening heartburn pictures and images of osteoporosis.
• Other, less serious side effects may be more likely to occur pictures and images of osteoporosis. Continueto take Actonel and talk to your doctor if you experience
· abdominal discomfort;
· stomach upset, nausea, vomiting, or diarrhea;
· headache; or
· muscle or joint soreness or aches pictures and images of osteoporosis.
• Side effects other than those listed here may also occur pictures and images of osteoporosis. Talk to yourdoctor about any side effect that seems unusual or that is especially bothersome pictures and images of osteoporosis.

What other drugs will affect Actonel?
• Do not take any other medicine, including vitamins, minerals, or othersupplements, at the same time as Actonel unless otherwise directed by your doctor pictures and images of osteoporosis. Any drug that is taken at the same time as Actonel can decrease the effectsof this medicine pictures and images of osteoporosis.
• Before taking this medication, tell your doctor if you are taking anyof the following medicines:
· an antacid;
· aspirin; or
· a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen (Motrin,Advil, Nuprin, others), ketoprofen (Orudis KT, Orudis, Oruvail), indomethacin(Indocin, Indocin SR), naproxen (Anaprox, Aleve, Naprosyn), oxaprozin (Daypro),nabumetone (Relafen), piroxicam (Feldene), and others pictures and images of osteoporosis.
• You may not be able to take Actonel, or you may require a dosage adjustmentor special monitoring during treatment if you are taking any of the medicineslisted above pictures and images of osteoporosis.
• Drugs other than those listed here may also interact with Actonel pictures and images of osteoporosis. Talkto your doctor and pharmacist before taking any prescription or over-the-countermedicines, including herbal products pictures and images of osteoporosis.

Where can I get more information?
• Your pharmacist has more information about Actonel written for healthprofessionals that you may read pictures and images of osteoporosis.

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