Generic Name: alendronate (a LEN dro nate)
Brand Names: Fosamax
What is alendronate?
Alendronate is in the group of medicines called bisphosphonates (bis FOS fo nayts). It alters the cycle of bone formation and breakdown in the body. Alendronate slows bone loss while increasing bone mass, which may prevent bone fractures.
Alendronate is used in men and women to treat or prevent osteoporosis that is caused by menopause or by taking steroids. Alendronate is also used to increase bone mass in men who have osteoporosis, and to treat Paget's disease of bone in men and women.
Alendronate may also be used for purposes not listed in this medication guide.
What is the most important information I should know about alendronate?
Do not take an alendronate tablet if you cannot sit upright or stand for at least 30 minutes. Alendronate can cause serious problems in the stomach or esophagus (the tube that connects your mouth and stomach). You will need to stay upright for at least 30 minutes after taking this medication.
Take the alendronate tablet first thing in the morning, at least 30 minutes before you eat or drink anything or take any other medicine.
Take each dose with a full glass (6 to 8 ounces) of water. Use only plain water (not mineral water, coffee, tea, or juice) when taking an alendronate tablet.
For at least the first 30 minutes after taking an alendronate tablet, do not lie down or recline; do not eat or drink anything other than plain water; and do not take any other medicines including vitamins, calcium, or antacids.
Some people using medicines similar to alendronate have developed bone loss in the jaw, also called osteonecrosis of the jaw. Symptoms may include jaw pain, swelling, numbness, loose teeth, gum infection, or slow healing after injury or surgery involving the gums. You may be more likely to develop osteonecrosis of the jaw if you have cancer or have been treated with chemotherapy, radiation, or steroids. Other conditions associated with osteonecrosis of the jaw include blood clotting disorders, anemia (low red blood cells), and a pre-existing dental problem.
If you need to have any dental work (especially surgery), tell the dentist ahead of time that you are using alendronate. You may need to stop using the medicine for a short time.
Talk with your doctor about the risks and benefits of using this medication.
What should I discuss with my healthcare provider before taking alendronate?
Do not take an alendronate tablet if you cannot sit upright or stand for at least 30 minutes. Alendronate can cause serious problems in the stomach or esophagus (the tube that connects your mouth and stomach). You will need to stay upright for at least 30 minutes after taking this medication. You should not take alendronate if you are allergic to it, or if you have low levels of calcium in your blood (hypocalcemia), or a problem with the movement of muscles in your esophagus.
To make sure you can safely take alendronate, tell your doctor if you have any of these other conditions:
trouble swallowing;
a vitamin D deficiency;
a dental problem;
kidney disease; or
an ulcer or other problem in your stomach or esophagus.
Some people using medicines similar to alendronate have developed bone loss in the jaw, also called osteonecrosis of the jaw. Symptoms may include jaw pain, swelling, numbness, loose teeth, gum infection, or slow healing after injury or surgery involving the gums.
You may be more likely to develop osteonecrosis of the jaw if you have cancer or have been treated with chemotherapy, radiation, or steroids. Other conditions associated with osteonecrosis of the jaw include blood clotting disorders, anemia (low red blood cells), and dental surgery or pre-existing dental problems.
Talk with your doctor about the risks and benefits of using this medication.
FDA pregnancy category C. It is not known whether alendronate will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. It is not known whether alendronate passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.
How should I take alendronate?
Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.
Alendronate tablets are taken either once each day or once each week.
Take the alendronate tablet first thing in the morning, at least 30 minutes before you eat or drink anything or take any other medicine. If you take an alendronate tablet only once a week, take it on the same day each week and always first thing in the morning.
Take each alendronate tablet with a full glass (6 to 8 ounces) of water. Use only plain water (not mineral water) when taking an alendronate tablet. Do not crush, chew, or suck the alendronate tablet. Swallow the pill whole.
After taking an alendronate tablet, carefully follow these instructions:
- Do not lie down or recline for at least 30 minutes after taking alendronate.
- Do not eat or drink anything other than plain water.
- Do not take any other medicines including vitamins, calcium, or antacids for at least 30 minutes after taking alendronate. It may be best to take your other medicines at a different time of the day. Talk with your doctor about the best dosing schedule for your other medicines.
To be sure this medication is helping your condition, your bone mineral density will need to be tested on a regular basis. Visit your doctor regularly.
If you need to have any dental work (especially surgery), tell the dentist ahead of time that you are using alendronate. You may need to stop using the medicine for a short time.
Alendronate is only part of a complete program of treatment that may also include diet changes, exercise, and taking calcium and vitamin supplements. Follow your diet, medication, and exercise routines very closely.
Store at room temperature away from moisture and heat.
See also: Alendronate dosage (in more detail)
What happens if I miss a dose?
If you take alendronate tablets once daily: If you forget to take this medicine first thing in the morning, do not take it later in the day. Wait until the following morning to take the medicine and skip the missed dose. Do not take two (2) tablets in one day.
If you take alendronate tablets once a week: If you forget to take alendronate on your scheduled day, take it first thing in the morning on the day after you remember the missed dose. Then return to your regular weekly schedule on your chosen dose day. Do not take two (2) tablets in one day.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Drink a full glass of milk and call your local poison control center or emergency room right away. Do not make yourself vomit and do not lie down.
Overdose symptoms may include nausea, heartburn, stomach pain, diarrhea, muscle cramps, numbness or tingling, tight muscles in your face, seizure (convulsions), irritability, and unusual thoughts or behavior.
What should I avoid while taking alendronate?
Avoid taking any other medicines including vitamins, calcium, or antacids for at least 30 minutes after taking an alendronate tablet. Some medicines can make it harder for your body to absorb alendronate. Do not lie down for at least 30 minutes after you take an alendronate tablet.
Alendronate side effects
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using alendronate and call your doctor at once if you have any of these serious side effects:
chest pain;
difficulty or pain when swallowing;
pain or burning under the ribs or in the back;
severe heartburn, burning pain in your upper stomach, or coughing up blood;
new or worsening heartburn;
fever, body aches, flu symptoms;
severe joint, bone, or muscle pain;
new or unusual pain in your thigh or hip;
jaw pain, numbness, or swelling.
Less serious side effects may include:
mild heartburn, bloating;
mild nausea, vomiting, or stomach pain;
diarrhea, gas, or constipation;
mild joint pain or swelling;
swelling in your hands or feet; or
dizziness, eye pain, headache.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Alendronate Dosing Information
Usual Adult Dose for Osteoporosis:
10 mg orally once a day.
-or-
70 mg orally once a week.
For glucocorticoid induced osteoporosis the initial dosage recommended is 5 mg orally once a day, except for postmenopausal women not receiving estrogen, for whom the recommended dosage is 10 mg orally once a day. Patients treated with glucocorticoids should receive adequate supplements of calcium and vitamin D.
Usual Adult Dose for Paget's Disease:
40 mg orally once a day.
Therapy for Paget's disease should continue for 6 months and may need to be repeated for another 6 months if relapse occurs.
Usual Adult Dose for Prevention of Osteoporosis:
For the prevention of postmenopausal osteoporosis:
5 mg orally once a day.
-or-
35 mg orally once a week.
What other drugs will affect alendronate?
Tell your doctor about all other medicines you use, especially aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as:
celecoxib (Celebrex);
diclofenac (Voltaren);
diflunisal (Dolobid);
ibuprofen (Motrin, Advil);
indomethacin (Indocin);
ketoprofen (Orudis)
ketorolac (Toradol);
naproxen (Aleve, Naprosyn); or
piroxicam (Feldene), and others.
This list is not complete and other drugs may interact with alendronate. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.
More alendronate resources
- Alendronate Side Effects (in more detail)
- Alendronate Dosage
- Alendronate Use in Pregnancy & Breastfeeding
- Drug Images
- Alendronate Drug Interactions
- Alendronate Support Group
- 9 Reviews for Alendronate - Add your own review/rating
- alendronate Advanced Consumer (Micromedex) - Includes Dosage Information
- Alendronate Prescribing Information (FDA)
- Alendronate MedFacts Consumer Leaflet (Wolters Kluwer)
- Alendronate Sodium Monograph (AHFS DI)
- Fosamax Prescribing Information (FDA)
- Fosamax Consumer Overview
Compare alendronate with other medications
- Aseptic Necrosis
- Osteoporosis
- Paget's Disease
- Prevention of Osteoporosis
Where can I get more information?
- Your pharmacist can provide more information about alendronate.
See also: alendronate side effects (in more detail)
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