low blood calcium, severe kidney disease, or cannot sit or stand for 30 minutes. follow all dosing instructions. stop taking actonel and tell your doctor if you experience difficult or painful swallowing, chest pain, or severe or continuing heartburn. these may be signs of serious upper digestive problems. promptly tell your doctor if you develop severe bone, joint, or muscle pain or develop dental problems as serious jawbone problems have beereported rarely. to get a free trial offer of once-a-month actonel, visit actonel.com. and ask your doctor how once-a-month actonel can help you reverse bone loss.