Alendronate, Oral Tablet

• Upper gastrointestinal issues: This drug may cause ulcers and erosions in your esophagus (the tube that connects your throat to your stomach). This can sometimes be severe. Symptoms may include heartburn, trouble swallowing or pain when swallowing, chest pain, bloody vomit, or black or bloody stool. Tell your doctor right away if you have these symptoms.
• Muscle and bone pain: This drug may cause severe bone, joint, and muscle pain. If you have these symptoms, stop taking alendronate and call your doctor right away.
• Osteonecrosis of your jaw: This drug can cause poor blood supply to your jaw. This may lead to osteonecrosis (bone death) of your jaw. This is more likely to occur after a major dental procedure. If you need to have dental work done, tell your doctor. You may need to stop taking this drug.
• Broken bones: This drug may cause unusual breaks in your hip or leg bones. You may have dull, aching pain in your thigh(s) or groin weeks or months before the bone breaks. If you have this pain, talk to your doctor.

Alendronate oral tablet is a prescription drug that’s available as the brand-name drugs Fosamax and Binosto. It’s also available as a generic drug.

Generic drugs usually cost less. In some cases, they may not be available in every strength or form as the brand-name version.

Alendronate also comes as an oral solution and an oral effervescent tablet.

Why it’s used

Alendronate is used to prevent and treat osteoporosis. With this condition, your bones become thin and weak, and break easily. This drug is also used to treat Paget’s disease. With this condition, your bones are soft and weak, and may be deformed or painful, or may break easily.

Alendronate may be used as part of a combination therapy with calcium and vitamin D supplements.

How it works

Alendronate belongs to a class of drugs called bisphosphonates. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Alendronate works by preventing bone breakdown and increasing the thickness of bone. This can make your bones strong and keep them from breaking.

Alendronate oral tablet doesn’t cause drowsiness but it can cause other side effects.

More common side effects

The more common side effects of alendronate oral tablet can include:

• stomach pain
• acid reflux
• constipation
• diarrhea
• upset stomach
• nausea
• muscle and joint pain

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

• Ulcers or erosions of your esophagus. Symptoms can include:
  • new or worsening heartburn
  • trouble swallowing
  • pain when swallowing
  • chest pain
  • bloody vomit
  • black or bloody stools
• Bone death of your jaw. Symptoms can include:
  • painful or swollen gums
  • loosening of your teeth
  • numbness or heavy feeling in your jaw
  • poor healing of your jaw
• Unusual bone breaks in your hip and leg bones. Symptoms can include:
  • dull, aching pain in your hips, groin, or thighs
• Hypocalcemia (low calcium levels in your blood). Symptoms can include:
  • spasms, twitches, or cramps in your muscles
  • numbness or tingling in your fingers, toes, or around your mouth
• Severe bone, joint, or muscle pain

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

Alendronate oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Examples of drugs that can cause interactions with alendronate are listed below.

Interactions that increase the risk of side effects

Taking alendronate with certain medications may cause more side effects. Examples of these drugs include:

• Aspirin and non-steroidal anti-inflammatory drugs (NSAIDs). You may have more upper gastrointestinal side effects, such as ulcers in your esophagus. Ask your doctor whether it’s safe for you to take these drugs together.

Interactions that can make your drugs less effective

When alendronate is used with certain drugs, it may not work as well to treat your condition. This is because the amount of alendronate in your body may be decreased. Examples of these drugs include:

• Calcium supplements, magnesium, iron, and antacids. These drugs may reduce how much alendronate your body absorbs. You should wait at least 30 minutes after taking alendronate before taking any other oral medications.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

This drug comes with several warnings.

Food interactions warning

You should take this drug on an empty stomach with a glass of water. Don’t take it with mineral water, coffee, tea, soda, or juice. Doing so may reduce the amount of this drug that your body absorbs. It may also increase the side effects. Wait at least 30 minutes after taking alendronate before having anything to eat or drink.

Alcohol interaction warning

Drinking alcohol can increase your risk of stomach side effects from alendronate. If you drink alcohol, talk to your doctor. They may monitor you closely for stomach problems.

Allergy warning

Alendronate can cause a severe allergic reaction. Symptoms can include:

• rash or hives
• swelling of your face, lips, or tongue
• trouble breathing

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 911 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

Warnings for certain groups

For people with esophagus problems: You shouldn’t take this drug. You’re more likely to have serious side effects, such as ulcers and erosions in your esophagus.

For people with low calcium blood levels: Your doctor should give you calcium supplements before you start taking this drug. Alendronate can make your condition worse.

For people with serious kidney problems: If you have severe kidney problems or a history of kidney disease, you may not be able to clear this drug from your body well. You shouldn’t take this drug.

For pregnant women: Alendronate is a category C pregnancy drug. That means two things:

1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Talk to your doctor if you’re pregnant or planning to become pregnant. This drug should only be used if the potential benefit justifies the potential risk to the fetus.

For women who are breastfeeding: It isn’t known if this drug passes into breast milk. If it does, it may cause side effects in a child who is breastfed. Talk to your doctor if you breastfeed your child. You may need to decide whether to stop breast-feeding or stop taking this medication.

For seniors: The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

For children: This medication shouldn’t be used in people younger than 18 years.

This dosage information is for alendronate oral tablet. All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

• your age
• the condition being treated
• how severe your condition is
• other medical conditions you have
• how you react to the first dose

Warnings

You should swallow this drug with a full glass of plain water (not mineral water) to make sure that the drug is delivered to your stomach. Also, you shouldn’t lie down for at least 30 minutes after you take the drug. You should also wait to lie down until after you’ve eaten your first food of the day. You should sit or stand. These steps will help prevent irritation of your esophagus.

Dosage for treatment and prevention of osteoporosis in postmenopausal women

Generic: Alendronate

• Form: oral tablet
• Strengths: 5 mg, 10 mg, 35 mg, 40 mg, 70 mg

• Form: oral solution
• Strength: 70 mg/75 mL

Brand: Fosamax

• Form: oral tablet
• Strength: 70 mg

Brand: Binosto

• Form: oral effervescent tablet
• Strengths: 70 mg

Adult dosage (ages 18 years and older)

• For treatment: 70 mg taken once per week or 10 mg taken once per day.
• For prevention: 35 mg taken once per week or 5 mg taken once per day.

Child dosage (ages 0–17 years)

This medication shouldn’t be used in people younger than 18 years.

Dosage for treatment of osteoporosis in men

Generic: Alendronate

• Form: oral tablet
• Strengths: 5 mg, 10 mg, 35 mg, 40 mg, 70 mg

• Form: oral solution
• Strengths: 70 mg/75 mL

Brand: Fosamax

• Form: oral tablet
• Strengths: 70 mg

Brand: Binosto

• Form: oral effervescent tablet
• Strengths: 70 mg

Adult dosage (ages 18 years and older)

70 mg taken once per week or 10 mg taken once per day.

Child dosage (ages 0–17 years)

This medication shouldn’t be used in people younger than 18 years.

Dosage for treatment of glucocorticoid-induced osteoporosis

Generic: Alendronate

• Form: oral tablet
• Strengths: 5 mg, 10 mg, 35 mg, 40 mg, 70 mg

Brand: Fosamax

• Form: oral tablet
• Strengths: 70 mg

Adult dosage (ages 18 years and older)

One 5-mg tablet taken once per day. If you’re a postmenopausal woman who isn’t receiving estrogen, the recommended dose is one 10-mg tablet taken once per day.

Child dosage (ages 0–17 years)

This medication shouldn’t be used in people younger than 18 years.

Dosage for treatment of Paget’s disease

Generic: Alendronate

• Form: oral tablet
• Strengths: 5 mg, 10 mg, 35 mg, 40 mg, 70 mg

Brand: Fosamax

• Form: oral tablet
• Strengths: 70 mg

Adult dosage (ages 18 years and older)

40 mg taken once per day for 6 months.

Child dosage (ages 0–17 years)

This medication shouldn’t be used in people younger than 18 years.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.

Alendronate oral tablet is used for long-term treatment. It comes with serious risks if you don’t take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all: If you don’t take this drug, you may have a higher risk for bone breaks.

If you miss doses or don’t take the drug on schedule: Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much: You could have dangerous levels of the drug in your body. Symptoms can include:

• upset stomach
• heartburn
• ulcers

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working: You may not be able to tell if alendronate is working since it increases the thickness of your bones. Your doctor may scan your bones with a machine to tell if the medication is working.

Keep these considerations in mind if your doctor prescribes alendronate oral tablet for you.

General

• Don’t take this drug with food. Food can reduce how much alendronate you absorb. Take it with a full glass of plain water.
• Take alendronate the first thing in the morning. Take it at least 30 minutes before any foods, beverages (except plain water), or other drugs.
• Don’t crush or cut alendronate tablets.

Storage

Don’t store this medication in moist or damp areas, such as bathrooms.

• Oral tablets: Store at room temperature between 59°F and 86°F (15°C and 30°C).
• Oral solution: Store at 77°F (25°C). You can store it briefly between 59°F and 86°F (15°C and 30°C). Don’t freeze this drug.
• Effervescent tablets: Store in their original package until you’re ready to use them. Keep them at a temperature between 68°F and 77°F (20°C and 25°C). You can store it briefly between 59°F and 86°F (15°C and 30°C). Keep the effervescent tablets in the packaging they come in until you’re ready to use them.

Refills

A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

• Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
• Don’t worry about airport x-ray machines. They can’t hurt your medication.
• You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
• Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Self-management

After you take this drug, you shouldn’t lie down for at least 30 minutes. You should also wait to lie down until after you’ve eaten your first food of the day. You should sit or stand. This will help prevent irritation of your esophagus.

Clinical monitoring

You and your doctor should monitor certain health issues. This can help make sure you stay safe while you take this drug. For instance, your doctor may do blood tests to check how well your kidneys are working. If your kidneys aren’t working well, your doctor may have you stop taking this drug.

Sun sensitivity

Alendronate can make your skin more sensitive to the sun. This increases your risk of sunburn. You should avoid being in the sun. If you must be outside, wear protective clothing and sunscreen.

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

Disclaimer: Healthline 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 other 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.