Alendronate sodium (
Fosamax®) is a prescription medication approved for the following uses:
- Treating osteoporosis in both men in women due to steroid medications, such as prednisone
- Preventing and treating osteoporosis in postmenopausal women
- Treating osteoporosis in men
- Treating Paget's disease in men and women.
Alendronate: What Should I Tell My Healthcare Provider?
You should talk with your healthcare provider prior to taking alendronate if you have:
- A narrowing of the esophagus (an esophageal stricture)
- Difficulty swallowing
- Low blood calcium (hypocalcemia)
- An inability to sit upright or stand for 30 minutes
- Kidney disease, including kidney failure (renal failure)
- Difficulty swallowing or other problems with your esophagus
- Any allergies, including allergies to food, dyes, or preservatives.
Also, let your healthcare provider know if you are:
- Pregnant or thinking of becoming pregnant
- Breastfeeding
- Planning to have a dental procedure.
Make sure to tell your healthcare provider about all medicines you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
As with any medicine, side effects are possible with alendronate. However, not everyone who takes the drug will experience side effects. In fact, most people tolerate it quite well. If side effects do occur, in most cases, they are minor and either require no treatment or can easily be treated by you or your healthcare provider. Serious side effects are less common.
Common side effects of alendronate include but are not limited to:
- Abdominal pain (stomach pain)
- Bone, muscle, or joint pain
- Indigestion or heartburn.
(Click Side Effects of Alendronate to learn more, including potentially serious side effects that you should report immediately to your healthcare provider.)
How Does Alendronate Work?
Alendronate belongs to a group of medications known as bisphosphonates. The drug binds to certain cells in bones and slows down the rate at which it breaks down.
Alendronate has been evaluated in several studies for various
osteoporosis-related uses.
Alendronate and Postmenopausal Women
Alendronate has been evaluated in four studies of postmenopausal women with osteoporosis. In these studies, the drug reduced the risk of vertebral fractures (broken spinal bones) by 48 percent. In women who already had a vertebral fracture before starting the drug, alendronate reduced the risk of a broken hip or wrist by about 50 percent. The studies also showed that the drug increased the bone mineral density (a measure of the strength of bones) in the spine and hip. Interestingly, women taking alendronate lost less height, compared with women not taking it.
Alendronate can also be used to prevent osteoporosis in postmenopausal women with risk factors for the disease. In studies, women taking the drug showed increased bone mineral density, while those not taking it actually experienced bone loss.
Alendronate and Men
Studies have shown that alendronate can help increase bone mineral density in men with
osteoporosis and can help prevent the loss of height due to the disease. Studies have not shown that the drug prevents broken bones in men. However, this is most likely due to the small number of men in alendronate studies (since studies need many people in order to show any changes in the frequency of broken bones).
Alendronate and Steroids
Osteoporosis is one of the side effects of long-term use of steroids, such as
prednisone. Studies have shown that alendronate can treat osteoporosis in people who take steroids. In these studies, people taking the drug had increased bone mineral density, compared to people not taking it.
Alendronate and Paget's Disease One way to assess the severity of Paget's disease is by measuring the level of alkaline phosphate in the blood. In studies, alendronate was shown to decrease alkaline phosphate levels, which indicates that it helps to improve Paget's disease. Studies compared alendronate with
Didronel® (
etidronate), a similar medication used to treat Paget's disease. Up to 85 percent of people taking alendronate achieved normal alkaline phosphate levels or significantly reduced levels, compared to just 30 percent of those taking Didronel.
When and How to Take Alendronate
General considerations for when and how to take alendronate include the following:
- The medication comes in tablet form. Depending on the dose, it is taken by mouth either daily or weekly. A liquid form of alendronate is also available to be taken weekly for people who have difficulty swallowing tablets.
- Alendronate must be taken first thing in the morning at least 30 minutes before you eat or drink anything (other than water). You must wait at least 30 minutes after taking the medication before eating or drinking anything other than water or taking any medications. Food, beverages, and medications can interact with alendronate and prevent it from being absorbed into the body.
- Take alendronate with a full glass of plain water only (not coffee, juice, soda, or even mineral water). With liquid alendronate, you should follow the dose with at least a quarter of a cup of plain water.
- Swallow the tablets whole with a full glass of water while sitting or standing upright. You must not lie down until you have waited at least 30 minutes after the dose and after you have eaten something. The tablets should not be chewed, broken, or sucked on. These precautions are necessary to prevent alendronate from irritating your esophagus.
- You need to make sure you get enough calcium and vitamin D while taking alendronate, as the medication cannot build bone without calcium and vitamin D.
- For the medication to work properly, it must be taken as prescribed. Alendronate will not work if you stop taking it.
Dosing Information for Alendronate
The dose of alendronate that your healthcare provider recommends will vary, depending on a number of factors, including:
- Whether you prefer to take alendronate daily or monthly
- Whether you are treating or preventing osteoporosis or treating Paget's disease
- Other medications you may be taking
- Other medical conditions you may have.
As is always the case, do not adjust your alendronate dose unless your healthcare provider specifically instructs you to do so.
Alendronate Drug Interactions
What If I Take an Overdose of Alendronate?
People who take too much alendronate may have overdose symptoms that could include:
- Upset stomach
- Heartburn or indigestion
- Ulcers
- Low levels of calcium or phosphate in the blood.
If you happen to overdose on alendronate, seek immediate medical attention.
How Should Alendronate Be Stored?
Alendronate tablets should be stored at room temperature, away from moisture and heat. Keep alendronate and all other medications out of the reach of children.
What Should I Do If I Miss a Dose of Alendronate?
If you forget to take your weekly dose of alendronate, take your dose on the first morning that you remember, and continue with your regular dosing schedule (do not change the day you normally take alendronate). However, do not take two doses of alendronate in one day.
If you take alendronate daily and you forget a dose, simply skip the missed dose. Do not take a double dose.
Alendronate tablets are available in the following strengths:
- Alendronate 5 mg (taken daily)
- Alendronate 10 mg (taken daily)
- Alendronate 40 mg (taken once daily for Paget's disease)
- Alendronate 35 mg (taken weekly)
- Alendronate 70 mg (taken weekly).
Liquid alendronate is also available -- Alendronate 70 mg oral solution (taken weekly). Each bottle contains one dose (70 mg) of alendronate in a raspberry-flavored liquid. Weekly alendronate also comes in tablets that contain a week's worth of vitamin D
(see Fosamax Plus D).
At this time, alendronate is available in generic form
(see Generic Fosamax).
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