經查證,上圖的sample是正统的Brand Name
下圖的 GENERIC Actonel 是成份相同的藥,價格便宜幾倍
卻只能在加拿大或英國才能買得到.150mg的問世不到一年.
這是治骨鬆的第?代藥品,每月只要服一顆150mg. 每顆約3000台幣.
台灣尚未進口. 家人中有醫生在美國,有sample藥.所以這是"恩典牌"
----免費的--是很大的恩賜.二個月前未通過 Fosamax Plus考驗,
希望actonel 150與我有緣. 以下為記錄追蹤:
1st Month
DAY 1 :.向骨鬆及胃腸科醫生諮詢,備好抵抗副作用藥物, 預定４天內不排活動計劃,
,,,,,,終於一切就緒. 上午,不確定皮膚紅疹及喉嚨炎時,能否服用Actonel?
打電話到美國詢問; 終於7:10am,空腹服下第一顆藥,
保持站立狀態 1小時後才吃早餐. 感謝上帝,迄今無恙. 4/5/10
DAY 2 : 副作用終於在第二天浮現; 頭痛、腹瀉、腹痛、似流感症狀. 早餐服用胃乳後止瀉.
下午胃酸逆流及流感症狀緩和...過敏紅疹加劇. 据說3~5天後,即可恢復正常.
似乎藥效每天釋放一些, 下個月應可好轉.今天整日昏睡. 4/6/10 ...
DAY 3....上午副作用症狀大為減輕 ; 有些腹脹. 過敏紅疹減輕. 下午輕瀉 4/7/10
DAY 4... 上午略有胃酸及軟便, 下午腹痛及腹瀉. 喝胃乳,服表飛鳴緩解症狀. 4/8/10
DAY 5....略有胃酸,服胃乳片. 希望大勢己去 4/9/10
DAY 6....似乎已克服不適, 期待下個月更好. 4/10/10
2 nd Month
DAY 1...6:30 am 先喝300cc白水,服下第二顆藥後,再喝500cc白水,‧8:00進食.
因正在服用過敏及關節炎止痛藥物,不知藥物之間的交互作用將會"拼出
什麽火花" ? 上帝!!這一切交在你手上,請你多看顧. 下午輕瀉一次 5/5/10
DAY 2...昨夜有流感症狀,發冷及口乾, 夜尿3次. 今天胃稍不適.
第二次服藥,症狀減輕許多,但望不要有後續紅疹發作. 5/6/10
DAY 3...今天雖有2次腹瀉,服胃乳2包,即得緩解,另服一次胃乳片. 5/7/10
DAY 4...Actonei 似乎已不構成威脅,沒有影响日常生活.希望明年此時.
我的脊椎骨能挺直不痛. 上帝的應許不會落空. 5/8/10
3 rd Month 上個有輕微小腿抽筋狀況,可能鈣磷缺乏所致.
DAY 1...為配合密集訓練的電腦課程.延遲一天服藥,
前一天先服兩次胃藥,今天相安無事. 6/6/10
DAY 2, DAY 3...這兩天均出現軟便及腹瀉,輕微發泠,
未確是副作用或端午食物的影响. 服用胃乳及止瀉藥.
不適狀況已減為2天. 感謝上帝. 6/7~8/10
DAY 4.....今天骨鬆科複診.
原則上,當我使用自購藥物時,医生不再負責追蹤及檢驗.
他認為FOSAMAX或ACTONEL的成份皆為双磷酸鹽.
希望我再回頭服用健保給付的FOSAMAX,(他才有用武之地)
他說問題不在藥物本身,而是心理接受與否? 我不願爭辯.
Actonel 150mg 間世不到一年,台灣沒進口,沒有病例可作比較..
根据研究報告, Actonel的效用比Fosamax高10倍.
每月2~3天的輕微不適是可以接受的. 只是藥價昂貴而己.6/9/10
4 th Month
DAY 1 已很確定, 副作用很少在第一天服藥時出現. 7/5/10
DAY 2 胃酸感與腹瀉在第二天下午發生. 胃乳,制酸劑及表飛嗚
是緩解不適的基本藥劑. 7/6/10
DAY 3 基本上, 每月呆在家中2天,侍侯這顆藥是必要的.
今天服双倍胃藥,胃部持續不適 . 7/7/10
DAY 4~7 這次胃部不適時間延長,時時要以制酸劑減輕症狀,
說明上提醒: 制酸劑會影响actonel的吸收,但
若不制止胃酸可能引起胃癀瘍. 7/12
服藥4個月的結論是: 每個月至少要撥2天,專門侍侯這顆藥.
已近7月底,消化障碍持續惡化,服用胃乳, gascon及制酸劑.
皆無法控制症狀.眼見即將服用第五顆,不知能通過考驗否?
Actonel真是顆不得不服的"毒藥"7/26/10
5 th Month
Day 1 該是服第5顆藥的日子.但胃腸障碍尚未恢復,再延後一天.
胃藥會使腎結石惡化,也會妨碍Actonel的吸收,唉!兩難. 8/5/10
Day 2 遲疑半天,清晨仍吞下第五顆藥. 午後胃酸上湧,腹脹如鼓,
服用消脹劑及胃乳,晚餐前後再加制酸劑.
感謝上帝.. 今天有些好轉. 8/6/10
Day 3 持續用胃藥控制, 維持正常作息. 不知胃藥中含有大量的氫氧化鋁,
是否會沉澱, 加速腎結石的形成 8/7/10
Day 4 仍有消化碍,需靠定時服用胃藥維持正常起居 8/8/10
Day 5 今天平安無事,感謝神!! 賜我意外的平安 8/9/10
近半年的軟組織疼痛及疲憊,應歸咎於那一種藥物???
6th Month 陸續收到有關藥物的負面消息,
DAY 1 清晨照例吞藥. 感謝上帝,上午做禮拜時,負作用不明顯.
午餐,晚餐前均喝下胃乳,一路平安. 9/5/10
DAY 2~3 腸胃症狀靠 胃藥緩解,起居正常 9/6~9/7/10
DAY 4 手指腫痛一個多月,也是累積負作用之一 9/8/10
7th Month
DAY 1 清晨照例吞藥. 晚餐前均喝下胃乳,
上背及膝蓋疼痛加劇,需服用Celebrex緩解10/5/10
DAY 2~3 腸胃症狀靠胃藥緩解,起居正常,仍軟便
下午復健科医生認為疼痛原因是再次的脊椎壓迫性骨折.
再服用Celebrex止痛. 似乎服了半年Actonel，
未見一絲成效?或是吸收不良? .再度穿獲背支撑 10/6/10
咋夜水瀉3次,今日白天又瀉3次,胃乳及Biotase也不見效.
我想是celebrex使腹瀉惡化.可是上背疼痛難忍 10/7/10
DAY 4 知是否該停藥.或改用針劑.
但談起藥物副作用,医生總認為是心理因素. 10/8/10
DAY 5~6 服用高劑量的乳酸菌,腹瀉及腸胃不適終於好轉.
胸椎6~8節處,仍有尖銳疼痛(是姿勢不良引起的小壓迫性骨折. 10/9~10/10
8 th Month
DAY 1-2 清晨照例吞藥. 前日晚餐前喝下胃乳, 並服闢節止痛消炎藥.
第二天依然水瀉 8次,服藥不能緩解,禁食固態食物一天.
11/6 X-RAY結果,膝蓋有大骨刺及球狀鈣化凸出物 導致發炎,極端疼痛.
医生替我注射類固醇+麻藥.緩解疼痛及跛腳.大概可不用置換人エ關節. 11/5~6/10
DAY 3 終於止瀉,卻無法正常進食.藥物使腸胃道受極大傷害,不知如何因應 11/7/10
DAY 4 今天骨科醫生宣佈不用做關節手術,鬆一口氣. 但至少需徹底躺下休息幾天.
這急性膝蓋發炎似乎與骨鬆無關. 今日中午終能正常進食.11/8/10
DAY 5~6 11/10 從腹瀉中脫困, 11/11再次注射類固醇+麻藥,
這是退化性關節炎, Actonel對它毫無幫助, 11/9~10/10
回頭看記錄‧每月5日服藥, 10日才能脫困,認命罷!
9 th Month DAY 1-2 未確定是否膝蓋軟骨或韌帶裂傷,止痛藥已破壞我的腸道系統, 服用ACTONEL 會更加惡化. 我想延後或暫停服藥. 11/5/10 DAY 3~8 膝蓋持續發炎, 暫時不服用Actonel 12/7~12
10 th Month
DAY......... 關節手術勢必在行,需停藥至關節恢復.遙想那一天!
10 th Month (2010)
My doctor suggested that I should stop taking Actonel
since I need surgery for right side of my knee 2 month later.
2011
膝蓋狀況漸趨穩定，雖然肌力訓練有些成效，
但免不了慢性疼痛. 手術治療似乎也無多大幫助。
日前又發生輕微胸椎壓迫性骨折，意圖恢復骨鬆藥療。
但副作用遠超過第一次用藥
7/29/11
7:30AM 空腹服下 Actonel 150mg & 500 cc water.
8: 30AM 早餐
11:30AM 午餐後 開始上吐下瀉，冒汗及頭痛。無法離開廁所。
12:30Pm 食物排空之後，服用胃乳，躺下休息 4:30PM 坐TAXI 就醫。
/30/11
77清晨水瀉三次，有些無力感。服用止瀉劑。進食不適
7/31.8/1~~8/3
血壓 低，畏冷，腹痛，虛弱，８／３才正常進食。很不愉快的經驗！
以下是搜尋的料,僅作參考:http://www.drugs.com/sfx/actonel-side-effects.html
Actonel 150mg---Once-a-Month
The safety of Actonel 150 mg administered once a month for
the treatment of postmenopausal osteoporosis was assessed(評價)
in a double-blind, multicenter study in postmenopausal women aged
50 to 88 years. The duration(持續時間) of the trial was one year,
with 642 patients exposed to Actonel 5 mg daily
and 650 exposed to Actonel 150 mg once-a-month.
Patients with pre-existing gastrointestinal(胃腸的) disease and
concomitant(相伴的)use of non-steroidal(含類固醇的)
anti-inflammatory(抗炎性及紅腫的)drugs,proton pump抽動inhibitors,
and H2 antagonists(對抗劑)were included in this clinical trial.
All women received 1000 mg of elemental calcium
plus up to 1000 IU of vitamin D supplementation per day.
The incidence(範圍)of all-cause mortality(失敗率)was 0.5% for
the Actonel 5 mg daily group and 0.0% for the Actonel 150 mg once-a-month group.
The incidence of serious adverse(有害的)events
was 4.2% in the Actonel 5 mg daily group and
6.2% in the Actonel 150 mg once-a-month group.
The percentage of patients who withdrew from treatment
due to adverse events was 9.5% in the Actonel 5 mg daily group
and 8.6% in the Actonel 150 mg once-a-month group.
The overall safety and tolerability(可忍受度)profiles of the
two dosing regimens were similar.
Acute(急性劇烈的)Phase Reactions:
Symptoms consistent with acute phase reaction have been reported
with bisphosphonate (a class of drugs that prevent the loss of
bone mass, used to treat osteoporosis)
The overall incidence of acute phase reaction was
1.1% in the Actonel 5 mg daily group and
5.2% in the Actonel 150 mg once-a-month group.
These incidence rates are based on reporting of
any of 33 acute phase reaction-like symptoms within
3 days of the first dose and
for a duration(持續時間)of 7 days or less.
Fever or influenza-like illness with onset within the
same period were reported by 0.2% of patients on Actonel 5 mg daily
and 1.4% of patients on Actonel 150 mg once-a-month.
Gastrointestinal(胃腸的)Adverse Events:
A greater percentage of patients experienced diarrhea with
Actonel 150 mg once-a-month compared to 5 mg daily
(8.2% vs. 4.7%, respectively).
The Actonel 150 mg once-a-month group resulted in a higher
incidence of discontinuation(多次停頓)due to abdominal pain upper
(2.5% vs. 1.4%) and diarrhea (0.8% vs. 0.0%)
compared to the Actonel 5 mg daily regimen.
All of these events occurred within a few days of the first dose.
The incidence of vomiting(嘔吐)that led to discontinuation was
the same in both groups (0.3% vs. 0.3%).
Ocular(眼睛的，視覺上的)Adverse Events:
None of the patients treated with Actonel 150 mg once-a-month
reported ocular inflammation such as uveitis, scleritis,
or iritis; 2 patients treated with Actonel 5 mg daily reported iritis.
Laboratory Test Findings: When Actonel 5 mg daily and
Actonel 150 mg once-a-month were compared in postmenopausal women
with osteoporosis, the mean percent changes from baseline at 12 months
were 0.1% and 0.3% for serum血清 calcium, -2.3% and
-2.3% for phosphate(磷酸鹽), and 8.3% and 4.8% for PTH,
respectively. Compared to the Actonel 5 mg daily regimen,
Actonel 150 mg once-a-month resulted in a slightly higher incidence
of hypocalcemia(低血鈣) at the end of the first month of treatment
(0.2% vs. 2.2%).
Thereafter, the incidence of hypocalcemia with
these regimens(攝生，食物療法) was similar at approximately 2%.
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