strontium ranelate and colecalciferol

M05BX53

Forms & Strengths

Combination pack: Strontium ranelate 2 g granules for oral suspension + Colecalciferol (Vitamin D3) 2000 IU or 10000 IU tablets

Adult Dosing

Strontium ranelate: 2 g once daily taken orally at bedtime
Colecalciferol: Dosing per national guidelines, often 2000 IU daily or 10000 IU weekly depending on deficiency and regimen requirements

Pediatric Dosing

Indications

Treatment of postmenopausal osteoporosis to reduce the risk of vertebral and hip fractures
Treatment of severe osteoporosis in adult men at high risk of fracture

Mechanism of Action

Strontium ranelate: Re-balances bone turnover by reducing bone resorption and maintaining bone formation, acting via the calcium-sensing receptor
Colecalciferol (Vitamin D3): Hydroxylated to 25-hydroxyvitamin D3 in the liver and then to the active metabolite calcitriol in the kidneys, increasing intestinal calcium and phosphate absorption and promoting bone mineralization

Contraindications

Hypersensitivity to strontium ranelate, colecalciferol, or excipients
Established, current, or history of ischemic heart disease, peripheral arterial disease, or cerebrovascular disease
Uncontrolled hypertension
Hypercalcemia or conditions leading to hypercalcemia (e.g., hyperparathyroidism, vitamin D toxicity)
Severe renal impairment (CrCl < 30 mL/min)
History of venous thromboembolism (VTE) or immobilized patients

Adverse Reactions

Common: Nausea, diarrhea, headache, eczema, venous thromboembolism
Uncommon: Pulmonary embolism, memory loss, hypersensitivity reactions, DRESS syndrome
Rare: Severe skin reactions (Stevens-Johnson syndrome, toxic epidermal necrolysis)
Colecalciferol related: Hypercalcemia, hypercalciuria (with excessive dosing)

Drug Interactions

Oral calcium supplements and food (especially dairy products) reduce strontium absorption; take strontium at least 2 hours apart
Antacids containing aluminum or magnesium reduce strontium absorption
Oral tetracyclines and quinolones: Strontium forms chelate complexes, reducing their absorption (separate administration by at least 2 hours)
Thiazide diuretics decrease urinary calcium excretion, increasing hypercalcemia risk with colecalciferol
Cardiac glycosides: High calcium levels from vitamin D toxicity can increase arrhythmia risk

Curated Content: Needs Vetting Before Put to Clinical Use