The absorption of the drug can be violated if the drug is taken simultaneously with calcium preparations, antacids and other drugs for oral administration. In this regard, the interval between and other medicines taken by mouth should be at least 30 minutes.
When used together steroid tren with hormone replacement therapy (estrogen + progestin) the safety and tolerability of combination therapy correspond to those in the application of each of these drugs alone . Olestra, mineral oils, orlistat, and bile acid sequestrants (Cholestyramine, colestipol) may impede the absorption . Anticonvulsants, cimetidine, thiazide diuretics can accelerate the catabolism o.
Like other bisphosphonates, may cause local irritation of the upper gastrointestinal tract. Patients receiving treatment , may experience adverse reactions such as esophagitis, esophageal ulcers and erosion, occasionally leading to the occurrence of esophageal stricture or perforation. In some cases, these adverse events may be severe and require hospitalization. Therefore, physicians should be particularly alert to any signs or symptoms suggestive of possible violations of the esophagus, and patients should be alerted about the need to stop taking steroid tren and seek medical advice in the event of their dysphagia, pain on swallowing or breastbone, new or worsening heartburn. The risk of severe adverse events from the esophagus is higher in patients who violate the guidelines for receiving the drug and / or continue to take it at the appearance of the symptoms of esophageal irritation. It is particularly important that the patient had a recommendation for receiving the drug, understood them and was informed that the risk of developing esophageal increases in case of failure of these recommendations.
There are rare cases of the appearance of gastric and duodenal ulcers, sometimes severe and complicated. However, in these cases, a causal relationship to drug intake has not been established.
be used with caution in patients with acute exacerbations of diseases of the upper gastrointestinal tract, such as dysphagia, oesophageal disease, gastritis, duodenitis and ulcers because of possible irritant on the mucosa of the upper gastrointestinal tract and worsening of the underlying disease.
There are cases of osteonecrosis of the jaw appearance of local, associated mainly with the previous tooth extraction and / or local infection due to delayed treatment, when administered bisphosphonates.Most of these cases have been reported in patients with cancer, the treatment of which was conducted intravenous bisphosphonates. Known risk factors for necrosis of the jaw are cancer detection, appropriate treatment (chemotherapy, radiotherapy, corticosteroids), poor oral hygiene, and co-morbidities (dental disease, anemia, coagulopathy, infection). Patients who have found a local osteonecrosis of the jaw should contact chelyusno surgeons.
Steroid trenbolone enanthate not recommended for patients with severe renal insufficiency due to lack of application experience in these patients.
It is necessary to take into account other causes osteoporosis, estrogen deficiency in addition, age, and use of corticosteroids.
in the presence of hypocalcemia in blood calcium level must be normalized prior to treatment . Other disorders of mineral metabolism (for example, deficiency of vitamin D) must also be eliminated. Patients with these disorders need to watch the blood levels of calcium and symptoms of hypocalcemia.
Because alendronate sodium increases mineral content in bones, can be observed small asymptomatic decrease in the level of calcium and phosphorus in the blood serum.
Supplementing with steroid tren may be considered on an individual basis.
Can increase the severity of hypercalcemia and / or hypercalciuria when used in patients with diseases associated with overproduction of calcitriol (leukemia, lymphoma, sarcoidosis). These patients should be monitored calcium levels in plasma and urine.
Patients with malabsorption may experience malabsorption .