Actonel (risedronate) is a brand-name oral tablet prescribed for osteoporosis and Paget disease in adults. As with other drugs, Actonel can cause side effects, such as abdominal pain or headache.

Actonel can cause certain side effects, some of which are more common than others. These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

These are just a few of the more common side effects reported by people who took Actonel in clinical trials:

Mild side effects can occur with Actonel. This list doesn’t include all possible mild side effects of the drug. For more information, you can refer to the drug’s prescribing information.

Mild side effects that have been reported with Actonel include:

These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you develop a side effect while taking Actonel and want to tell the FDA about it, visit MedWatch.

Actonel may cause serious side effects, but they aren’t common. The list below may not include all possible serious side effects of the drug. For more information, you can refer to the prescribing information for Actonel.

If you develop serious side effects while taking Actonel, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Serious side effects that have been reported and their symptoms include:

  • hypocalcemia (low blood calcium), which may include symptoms such as:
    • muscle spasms
    • dry skin
    • fatigue
    • numbness or tingling in your fingers or toes or around your mouth
  • cataracts, which may include symptoms such as:
  • fracture in your femur (thigh bone), which may cause symptoms such as:
    • an aching or dull pain in your thigh or groin
  • Pain in your muscles, joints, or bones
  • upper gastrointestinal (GI) problems (see “Side effect specifics” below)
  • osteonecrosis in the jaw (see “Side effect specifics” below)

For some people, Actonel tablets can cause an allergic reaction.

In general, symptoms of allergic reaction can be mild or serious. You can learn more about possible symptoms in this article.

Ways to manage

For mild allergic reaction symptoms, such as a mild rash, call your doctor right away. They may recommend treatments to help manage your symptoms. They’ll also let you know whether you should keep taking the medication.

For severe allergic reaction symptoms, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms require immediate medical care because they can become life threatening. If you’ve had a serious allergic reaction to Actonel, your doctor may recommend taking a different medication instead.

Actonel may cause several side effects. Here are some frequently asked questions about the drug’s side effects and their answers.

Can Actonel cause weight gain?

No, weight gain wasn’t reported as a side effect by people who took Actonel in clinical trials. However, in some people, Actonel can cause peripheral edema (fluid buildup and swelling in the hands, arms, legs, or feet). It’s possible that this could cause a temporary increase in your weight.

Talk with your doctor or pharmacist if you have concerns about changes in weight while taking Actonel. They can suggest ways to maintain a healthy weight that’s right for you.

Are side effects of Actonel doses once a week similar to those of Actonel doses once a month?

It’s not known for certain how side effects compare with different dosing schedules of Actonel. There hasn’t been a direct comparison of Actonel side effects based on the dosing schedule.

Depending on the condition being treated, doctors may prescribe Actonel once daily, weekly, or monthly. In clinical studies, side effects reported with monthly and daily doses of Actonel were similar overall. However, abdominal pain and diarrhea were reported more frequently by people who took Actonel monthly compared to daily.

Talk with your doctor or pharmacist if you have questions about the side effects of Actonel with different dosing schedules. Learn more about Actonel dosages.

Is Actonel safe for older adults?

In general, yes. Actonel was shown to be safe and effective in older adults (ages 65 years and older) taking the drug in clinical studies. However, older adults may be more sensitive to some side effects of the drug, such as diarrhea or abdominal pain.

Older adults may have lower kidney function than other adults, increasing their risk of side effects. This is because the kidneys help remove drugs, including Actonel, from the body. If the kidneys aren’t working well, Actonel may stay in the body longer, increasing the risk of side effects. To learn more, see “Mild side effects of Actonel” above.

Talk with your doctor if you have questions or concerns about whether Actonel is a safe option for you. They can also advise you about other treatment options for your condition.

Can Actonel cause long-term side effects?

It’s possible, but most side effects of Actonel last for a few days to weeks. They typically go away as your body gets used to the medication.

Yet some side effects, such as bone pain or osteonecrosis of the jaw, can start at any time during treatment and may last for a longer period of time. To learn more about jaw osteonecrosis, see the “Side effect specifics” section below.

Actonel stays in your system for a long time after you stop taking the medication. For this reason, it might take some time for side effects to fully resolve after discontinuing the medication.

If you have questions or concerns about the long-term use of Actonel, talk with your doctor or pharmacist.

Learn more about some of the side effects that Actonel may cause. To find out how often side effects occurred in clinical trials, see the prescribing information for Actonel.

Upper GI problems

Actonel can cause irritation or ulcers in the throat and esophagus. These structures are part of the upper GI tract (digestive system). This side effect wasn’t common in people taking Actonel in clinical studies. However, in rare cases, these side effects cause serious bleeding and may require hospitalization.

Symptoms of upper GI problems may include:

What you can do

To help prevent GI problems such as ulcers, it’s important to take Actonel as prescribed by your doctor. Always follow the directions provided by your doctor or pharmacist on how to take the medication.

You should take Actonel with a full (6- to 8-ounce) glass of plain water while standing or sitting upright. Also, avoid lying down for at least 30 minutes after you take the tablet. Learn more about taking Actonel in this article.

If you notice any of the symptoms listed above while taking the medication, talk with your doctor right away. They’ll determine whether you should continue taking the drug.

Osteonecrosis of the jaw

Rarely, osteonecrosis of the jaw has been reported with Actonel and similar drugs. (Actonel belongs to the bisphosphonate drug class.) Osteonecrosis is when cells in bone tissue die. In people taking Actonel, it may occur unexpectedly but typically happens after a tooth is pulled or a dental infection that doesn’t heal well.

Symptoms of jaw osteonecrosis may include:

  • jaw pain
  • loosening teeth
  • exposed jaw bone from your gums
  • tingling or numbness in your mouth
  • poor healing after dental surgery or jaw damage
  • painful or swollen gums

You may have a higher risk of jaw osteonecrosis the longer you take Actonel. Other factors that may increase the risk of osteonecrosis include:

What you can do

Practicing good oral hygiene, including brushing and flossing regularly, can help reduce the risk of osteonecrosis.

If you need to have an invasive dental procedure, such as a tooth extraction or dental implants, tell your doctor or oral surgeon. They may recommend that you stop taking Actonel before your procedure. If the doctor temporarily pauses Actonel, they’ll tell you when it’s safe to restart treatment.

Before taking Actonel, discuss your health history with your doctor. Actonel may not be right for you if you have certain medical conditions or other factors affecting your health. Be sure to talk with your doctor if any of the following apply to you:

If you’d like to learn more about osteoporosis, explore this list of osteoporosis articles.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.