Strontium ranelate is a substance that can affect the metabolic processes in bone tissue. Clinical studies show that it is able to stimulate bone formation, replication of osteoblastic progenitors and collagen production, reduce bone resorption by suppressing resorptive activity and differentiation of osteoclasts.
It is an active component in a number of medications used for the treatment of postmenopausal osteoporosis, as well as for the correction of metabolic processes in cartilage and bone tissue.
The most popular strontium ranelate preparations are Stromos, Strometa, Bivalos. In essence, they are analogues of each other, as they have the same active substance in their composition. In this regard, the mechanism of action of the component can be considered on the example of one of these drugs - Bivalos. The instructions for strontium ranelate must be strictly observed.
Pharmacological forms
Bivalos is produced by the manufacturer in the form of a powder having a pale yellow color and intended for the manufacture of a suspension. Powdered in a sachet of 2 grams. Each cardboard packaging can accommodate 7, 14, 28, 56, 84, 100 sachets.
Structure
Each Bivalos sachet contains 2532 mg of strontium ranelate as an active substance in the form of a hydrate, which corresponds to 2000 mg of anhydrous strontium ranelate. Auxiliary components are also used: maltodextrin, aspartame, mannitol. The drug is able to correct metabolism in bone, cartilage.
Pharmacodynamics and pharmacokinetics
In vitro studies show that strontium ranelate can activate bone formation. The substance also takes part in the synthesis of collagen and helps stimulate the production of osteoblastic precursors.
Against the background of the use of strontium ranelate, the rate of bone tissue resorption decreases, thereby stopping the process of osteoclast differentiation. Under the influence of the component, the process of destruction of bone tissue is replaced by the process of its formation. Thus, the substance starts the process of bone tissue regeneration in osteoporosis in the body.
Long-term therapy (more than 3 years) allows you to increase the level of biochemical markers responsible for bone synthesis, as well as reduce the level of markers present, leading to bone resorption.
The drug is highly effective in the treatment of postmenopausal osteoporosis, when the likelihood of fractures increases. Strontium ranelate also shows good results when used for the treatment of osteoarthrosis. The active component takes part in the synthesis of the cartilage matrix, is able to exert an effect on human chondrocytes, thereby slowing down the process of tissue destruction.
Indications for use
According to the instructions for strontium ranelate, it is indicated for use in the treatment of the following conditions:
- Osteoporosis in men.
- Osteoporosis of the knee, hip joints.
- Postmenopausal osteoporosis, prevention of fractures.
Also, the drug is used as an element of the complex treatment of fractures, for example, the femoral neck.
Contraindications
Strontium ranelate is contraindicated in the presence of the following physiological or pathological conditions:
- Hypertension
- Arterial diseases.
- Cerebrovascular disease.
- Coronary artery disease.
- Immobilization.
- Thromboembolism of arteries in the lungs.
- Vein thrombosis.
- Venous thromboembolism.
- Hypersensitivity to the substance.
It is forbidden to use preparations based on strontium ranelate according to the instructions for use for the treatment of pediatric patients. Caution should be exercised in the treatment of patients suffering from venous thromboembolism, renal failure.
Negative impact
Nervous system, gastrointestinal tract, cardiovascular system can respond to the use of strontium ranelate by the occurrence of the following negative reactions:
- Venous thromboembolism.
- Lesions of the mucous layers, for example, the formation of ulcerative lesions in the oral cavity.
- Stomatitis.
- Diarrhea.
- Nausea.
- Loose stool.
- Vomiting
- Impaired consciousness.
- Impaired memory.
- Cramps.
- Headache.
Also, against the background of the use of the medicine strontium ranelate, allergic manifestations may occur in the form of eczema, dermatitis, urticaria, skin itching, rash.
Using Bivalos
The drug is intended for oral use. From the Bivalos powder, a suspension should be prepared before use. Experts recommend taking a dose before bedtime. The maximum effect will be obtained if the patient immediately takes a horizontal position after using the drug.
2 grams of the drug should be taken per day, which corresponds to 1 sachet. An independent increase in dosage is unacceptable, since otherwise there is a likelihood of an overdose. To prepare a suspension of the powder, you need to use about a third of a glass of water.
Two hours before using the drug, it is necessary to minimize the use of foods saturated with calcium, since in its presence the rate of absorption of strontium renalate decreases, respectively, and its effectiveness. If a patient has a deficiency of calcium and vitamin D during therapy, it is indicated to supplement the therapy with drugs that make up for the deficiency of important elements.
Overdose
An overdose, as well as the negative consequences of the use of strontium renelate, rarely occurs, even if the specified amount is exceeded. However, it is impossible to completely exclude the probability of its occurrence. Therefore, when it occurs, it is recommended to take measures aimed at removing the active substance from the body and reducing its absorption. The patient should induce vomiting, rinse the stomach and consume foods rich in calcium, such as milk or its derivatives.
Interaction with other medicines
It is not recommended to take the drug together with dairy products and milk, it is necessary to withstand a two-hour break between their intake. This will avoid a decrease in the absorption rate of the active substance. A similar rule should be observed with the parallel use of antacid drugs. When used together, the effectiveness of tetracycline and quinoline antibiotics decreases.
Special instructions for use
When carrying out drug therapy, patients suffering from kidney failure should constantly monitor the correct functioning of the kidneys. Against the background of the use of strontium ranelate, there is a risk of developing venous thromboembolism, and specialists could not establish the causes of this phenomenon. In this regard, caution should be exercised when prescribing the drug to patients at risk.
The use of the drug can provoke the occurrence of a variety of skin reactions, for example, dress syndrome, epidermal necrolysis, eosinophilia, drug rash, Stevens-Johnson syndrome. With the development of these unpleasant and sometimes dangerous symptoms, the use of a medicine based on strontium ranelate should be discontinued.
Strontium present in the preparation is able to influence the results of calometric studies aimed at determining the presence of potassium in urine and blood. In this regard, in order to obtain more accurate results, it is recommended to use other methods, for example, atomic emission or absorption spectrometry.
Aspartame is present in the composition of the drug, which can provoke negative effects in patients with phenylketonuria. The substance does not affect the patient's ability to drive complex mechanisms and vehicles.
Analogs of strontium ranelate
Direct analogues of Bivalos are all drugs that have a similar component in their composition. These include "Ikszheva", "Osteogenon", "Prolia", "Stromos", "Strontium renelate", "Stromata".
Indications of the drug "Stromos":
Treatment of severe osteoporosis with a high risk of fractures:
- in women in the postmenopausal period;
- in adult men
- provided that other therapy cannot be prescribed for the treatment of osteoporosis as a result of, for example, intolerance, contraindications, etc.
In postmenopausal women, strontium ranelate reduces the risk of hip and vertebral fractures. The decision to prescribe it should be based on an individual assessment of the total risks of each patient. Treatment of osteoporosis should be initiated only as directed by a doctor with experience in the treatment of such an ailment.
If it is necessary to replace the drug, consult a specialist, since each drug has specific contraindications and can provoke a variety of negative manifestations.
Use of the drug in the treatment of children
The use of strontium ranelate-based drugs in the treatment of pediatric patients is not recommended. Such a ban is due to the lack of a sufficient amount of data indicating the safety of the drug.
Use in the lactation period and during pregnancy
The use of drugs in the treatment of pregnant women is prohibited. Also, strontium ranelate is able to be excreted together with breast milk. Therefore, when it becomes necessary to use it in the lactation period, a woman must first stop natural feeding.
Drug cost
The average cost of Bivalos in Russian drugstores depends on the number of sachets per pack, the region where the drug is distributed, and the pricing policy of the pharmacy chain. On average, a package containing 28 sachets will cost 1850 rubles. Analogs of Bivalos, incorporating the same active component, can cost both cheaper and more expensive. It all depends on the drug, its manufacturer and other factors.
Strontium ranelate reviews
Most of the responses about the experience of using such drugs suggest its high effectiveness in the treatment of osteoporosis. Against the background of the use of the drug, normalization of the mineral composition of bone tissues, correction of metabolic processes in cartilage tissues are noted. Patients report good results in the treatment of fractures that occur with osteoporosis, which avoids the intervention of surgeons.
The disadvantages are a rather high cost of the drug, which is important for many patients. After all, drug therapy often takes a long time. It is also reported that with the use of strontium ranelate, negative effects such as stomach pain often develop.
It is important to understand that the appointment of the drug should be carried out by a doctor, and only after a clinical examination and determine the feasibility of using this particular drug.