If you have certain conditions that cause weak bones, your doctor might suggest Fosamax (alendronate) as a treatment option for you. As a result, you could be looking for more information about the drug, such as details about dosage.

Fosamax is a prescription medication that’s used in adults to:

This article describes the dosages of Fosamax, including its form, strength, and how to take the drug. To learn more about Fosamax, see this in-depth article.

Note: This article covers Fosamax’s typical dosages, which are provided by the drug’s manufacturer. But when using Fosamax, always take the dosage that your doctor prescribes.

* In this article, we use the terms “male” and “female” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.

Your doctor will prescribe your dosage of Fosamax based on the type of condition you’re taking the drug to treat.

What is Fosamax’s form?

Fosamax only comes as a tablet that you take by mouth. It’s no longer made in a liquid form.

Fosamax contains the active drug alendronate. Alendronate is available as a generic medication that comes in two forms: a tablet and a liquid that you take by mouth.

Fosamax’s strength (70 mg)

Fosamax comes in one strength: 70 milligrams (mg).

Fosamax contains the active drug alendronate, which is available as a generic medication. Alendronate tablets come in the following strengths: 5 mg, 10 mg, 35 mg, 40 mg, and 70 mg.

Different strengths of the drug are used depending on the type of condition you’re taking it to treat. (For more information, see the “Frequently asked questions” section below.)

What are the typical dosages of Fosamax?

Your doctor may adjust your dosage over time to find the amount that’s best for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The information below describes dosages that are commonly used or recommended. But be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Dosage for treating or preventing osteoporosis in females who’ve gone through menopause

Fosamax is used to treat or prevent osteoporosis in females* after menopause. There are two options for the dosage frequency of the drug. Many people find that the weekly dosage is more convenient. You and your doctor can discuss the dosage instructions and decide what works best for you.

To treat osteoporosis after menopause, you’ll likely take one 70-mg tablet of Fosamax (or alendronate) once each week. Alternatively, your doctor may prescribe a 10-mg daily dose of alendronate.

To prevent osteoporosis after menopause, you’ll likely take one 35-mg tablet of alendronate once weekly. Alternatively, your doctor may prescribe a 5-mg dose of alendronate that you take once each day.

* In this article, we use the term “female” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.

Dosage for treating osteoporosis in males

Fosamax is used to treat osteoporosis in males.* There are two options for the dosage frequency of the drug. Many people find that the weekly dosage option is more convenient. You and your doctor can discuss these options and decide what works best for you.

For this use, you’ll likely take one 70-mg tablet of Fosamax (or alendronate) once each week. Alternatively, your doctor may prescribe a 10-mg daily dose of alendronate.

* In this article, we use the term “male” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.

Dosage for treating osteoporosis caused by steroids

Alendronate, the generic version of Fosamax, is used to treat osteoporosis that’s caused by taking certain steroid drugs.* Specifically, taking glucocorticoids such as prednisone may lead to osteoporosis. For this use, you’ll take the drug once each day.

To treat osteoporosis caused by steroids, you’ll likely take one of the following dosages:

  • 5 mg of alendronate once daily, or
  • 10 mg of alendronate once daily if you’re a female† who’s gone through menopause and you’re not taking a medication that contains estrogen

* Fosamax doesn’t come in small enough doses for this use.

† In this article, we use the term “female” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.

Dosage for treating Paget’s disease of bone

Alendronate, the generic version of Fosamax, is approved to treat a condition called Paget’s disease of bone.* For this use, you’ll take the drug once each day.

After 6 months of treatment, you’ll stop taking this drug. Then your doctor will check your blood level of alkaline phosphatase (ALP). If your ALP level is too high, your doctor may have you restart the drug.

To treat Paget’s disease of bone, you’ll take one 40-mg tablet of alendronate once daily.

* Fosamax doesn’t come in small enough doses for this use.

Is Fosamax used long term?

Yes, Fosamax is typically used as a long-term treatment. If you and your doctor determine that Fosamax is safe and effective for you, it’s likely that you’ll use it long term.

This section explains how to take Fosamax to treat osteoporosis in males and in females* who’ve gone through menopause. For questions about how to take other strengths and forms of alendronate for other uses, talk with your doctor or pharmacist.

Fosamax comes in 70-mg tablets that you’ll take by mouth once each week. You can choose the day that’s best for you, because you should take the drug on the same day each week.

It’s very important to follow these instructions for how to take Fosamax: When it’s your day of the week to take Fosamax, swallow the tablet first thing in the morning on an empty stomach. Take the tablet with 6 to 8 ounces of plain water.

For at least 30 minutes after you take your dose, you should not lie down. You may stand or sit, but keep your upper body in an upright position. If you lie down before 30 minutes have passed, Fosamax may cause damage to your esophagus. (The esophagus is the tube that connects your mouth to your stomach.)

During this 30 minutes, you also should not take any medications or supplements, or eat or drink anything besides water.

If you have any questions about how to take Fosamax, talk with your doctor or pharmacist.

* In this article, we use the terms “male” and “female” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.

Get answers to frequently asked questions about the dosage of Fosamax.

How does the 70-mg Fosamax tablet differ from the generic form of the drug?

There’s no difference between the 70-milligram (mg) Fosamax tablet and its generic form, the 70-mg alendronate tablet.

They both contain the same active drug, which is alendronate. Fosamax only comes as a 70-mg tablet. Alendronate comes as a tablet that’s available in several strengths (5 mg, 10 mg, 35 mg, 40 mg, and 70 mg).

The main reason that doctors prescribe Fosamax is to treat osteoporosis. The most commonly prescribed dosage of Fosamax for osteoporosis is 70 mg once weekly. Many people find once-weekly dosing more convenient than once-daily dosing.

People often opt for generic drugs because they’re less expensive than their brand-name versions. The other strengths of the drug aren’t as commonly prescribed as the 70-mg tablet. It’s likely that the manufacturer of Fosamax stopped producing other strengths for business reasons.

You’ll take alendronate, the generic version of Fosamax, if your doctor prescribes the drug:

  • once daily to treat or prevent osteoporosis
  • to treat osteoporosis caused by taking steroid medications
  • to treat Paget’s disease of bone

If you have questions about Fosamax or alendronate, talk with your doctor or pharmacist.

Can I take a monthly dose of Fosamax instead of a weekly one?

No, there isn’t a monthly dosage option for Fosamax.

There are other once-monthly medications available to prevent or treat osteoporosis. One example is Boniva (ibandronate).

It’s best to discuss these treatment options with your doctor. They can recommend a medication and dosage that’s best for your condition.

If you miss a dose of Fosamax, you should take it first thing the next morning. Don’t take your missed dose later in the day. Then, continue taking Fosamax once weekly (or alendronate once daily) as prescribed by your doctor.

If you have questions about what to do after missing a dose of Fosamax, talk with your doctor or pharmacist.

To help make sure you don’t miss a dose, try using a medication reminder. Setting an alarm or putting a note on your calendar can be helpful, too.

The dosage of Fosamax you’re prescribed depends on the type and severity of the condition you’re using Fosamax to treat.

Don’t use more Fosamax than your doctor prescribes. Using more than this can lead to serious side effects.

Symptoms of overdose

Signs and symptoms of an overdose of Fosamax can include:

What to do in case you take too much Fosamax

Call your doctor right away if you think you’ve taken too much Fosamax. You can also call 800-222-1222 to reach the American Association of Poison Control Centers, or use its online resource. But if you have severe symptoms, call 911 (or your local emergency number) immediately or go to the nearest emergency room.

The sections above describe the typical dosages of Fosamax provided by the drug manufacturer. If your doctor recommends Fosamax for you, they’ll prescribe the dosage that’s right for you.

Remember, you shouldn’t change your dosage of Fosamax without your doctor’s recommendation. Only take Fosamax exactly as prescribed. Talk with your doctor if you have questions or concerns about your current dosage.

Here are some questions to get a conversation started with your doctor:

  • Should my dosage increase if Fosamax isn’t working well enough for me?
  • Would reducing my dosage lower my risk of side effects from Fosamax?
  • Is there another drug that’s similar to Fosamax but has a less frequent dosage?
  • Does my dosage of Fosamax need to change if I’m taking other drugs or supplements with it?

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 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.