Strontium Ranelate

Registered South African indications:

• Osteoporosis

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients
• Current or previous venous thromboembolic events
• Temporary or permanent immobilisation
• Current or history of ischaemic heart disease, peripheral arterial disease, or cerebrovascular disease
• Uncontrolled hypertension

Cautions

• Pregnancy
• Breastfeeding 
• Severe renal impairment
• Risk factors for cardiovascular events
• Risk of venous thromboembolism
• Asian patients
• Presence of HLA-A*33:03 allele 
• Presence of HLA-B*58:01 allele 

Forms avail. in SA and covered in this monograph: gra

Treatment of post-menopausal osteoporosis 
- to reduce the risk of vertebral and peripheral fractures

• Oral (gra): 2g, dly

Granules must be taken as a suspension in a glass of water

Should be taken at bedtime at least 2 hours after eating to enhance absorption

Should be administered with vitamin D and calcium supplementation if dietary intake is insufficient

Not established for use in children

Pregnancy

• FDA Pregnancy Category Not Rated (NR)

Breastfeeding

• Caution; not recommended

Renal Impairment

• Severe: Caution; dose adjustment recommended

Hepatic Impairment

• No dose adjustment recommended

Elderly

• No dose adjustment recommended

Central Nervous System Disorders

• Insomnia
• Confusion
• Headache
• Disturbances in consciousness
• Memory loss
• Dizziness
• Paraesthesia
• Seizures
• Malaise

Cardiovascular Disorders

• Myocardial infarction
• Venous thromboembolism 

Respiratory Disorders

• Bronchial hyperreactivity

Gastrointestinal Disorders

• Nausea and vomiting
• Diarrhoea
• Abdominal pain
• Gastrointestinal pain
• Gastrooesophageal reflux
• Dyspepsia
• Constipation
• Flatulence
• Stomatitis
• Mouth ulceration
• Dry mouth

Hepatobiliary Disorders

• Hepatitis
• Increased serum transaminase

Endocrine and Metabolic Disorders

• Hypercholesterolaemia
• Increased creatine phosphokinase

Musculoskeletal Disorders

• Muscle spasm
• Myalgia
• Bone pain
• Arthralgia
• Pain in extremity
• Peripheral oedema

Skin and Subcutaneous Tissue Disorders

• Rash
• Pruritus
• Urticaria
• Angioedema
• Eczema
• Dermatitis
• Alopecia
• Drug reaction with eosinophilia and systemic symptoms 
• Severe cutaneous adverse reactions
• Stevens-Johnson syndrome
• Toxic epidermal necrolysis

Immune, Blood and Lymphatic System Disorders

• Lymphadenopathy
• Bone marrow failure
• Eosinophilia
• Pyrexia

Sensory Disorders

• Vertigo

• Food
• Milk and milk derivatives
• Tetracyclines
• Quinolones
• Aluminium
• Magnesium hydroxides

None routine

Strontium has a dual effect on bone metabolism. It promotes bone formation by increasing the replication of osteoblast precursors, as well as reducing bone resorption by decreasing osteoclast differentiation.

Granules (per sachet) 2g

• Protos (Servier) originator (Discontinued: 07/03/2018)