Alendronate Tablets

Alendronate is a medication that treats osteoporosis. It can also treat Paget disease of the bone. It works by making your bones stronger and less likely to break. This medication comes in a tablet form, and the brand name is Fosamax®.

What is this medication?

ALENDRONATE (a LEN droe nate) prevents and treats osteoporosis. It may also be used to treat Paget disease of the bone. It works by making your bones stronger and less likely to break (fracture). It belongs to a group of medications called bisphosphonates.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.



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What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

  • Bleeding disorder
  • Cancer
  • Dental disease
  • Difficulty swallowing
  • Infection (fever, chills, cough, sore throat, pain or trouble passing urine)
  • Kidney disease
  • Low levels of calcium or other minerals in the blood
  • Low red blood cell counts
  • Receiving steroids like dexamethasone or prednisone
  • Stomach or intestine problems
  • Trouble sitting or standing for 30 minutes
  • An unusual or allergic reaction to alendronate, other medications, foods, dyes or preservatives
  • Pregnant or trying to get pregnant
  • Breast-feeding

How should I use this medication?

Take this medication by mouth with a full glass of water. Take it as directed on the prescription label at the same time every day. Take the dose right after waking up. Do not eat or drink anything before taking it. Do not take it with any other drink except water. Do not chew or crush the tablet. After taking it, do not eat breakfast, drink, or take any other medications or vitamins for at least 30 minutes. Sit or stand up for at least 30 minutes after you take it. Do not lie down. Keep taking it unless your care team tells you to stop.

A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

Talk to your care team about the use of this medication in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.


What if I miss a dose?

If you take your medication once a day, skip it. Take your next dose at the scheduled time the next morning. Do not take two doses on the same day.

If you take your medication once a week, take the missed dose on the morning after you remember. Do not take two doses on the same day.

What may interact with this medication?

  • Aluminum hydroxide
  • Antacids
  • Aspirin
  • Calcium supplements
  • Medications for inflammation like ibuprofen, naproxen, and others
  • Iron supplements
  • Magnesium supplements
  • Vitamins with minerals

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.


What should I watch for while using this medication?

Visit your care team for regular checks on your progress. It may be some time before you see the benefit from this medication.

Some people who take this medication have severe bone, joint, or muscle pain. This medication may also increase your risk for jaw problems or a broken thigh bone. Tell your care team right away if you have severe pain in your jaw, bones, joints, or muscles. Tell you care team if you have any pain that does not go away or that gets worse.

Tell your dentist and dental surgeon that you are taking this medication. You should not have major dental surgery while on this medication. See your dentist to have a dental exam and fix any dental problems before starting this medication. Take good care of your teeth while on this medication. Make sure you see your dentist for regular follow-up appointments.

You should make sure you get enough calcium and vitamin D while you are taking this medication. Discuss the foods you eat and the vitamins you take with your care team.

You may need blood work done while you are taking this medication.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

  • Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
  • Low calcium level—muscle pain or cramps, confusion, tingling, or numbness in the hands or feet
  • Osteonecrosis of the jaw—pain, swelling, or redness in the mouth, numbness of the jaw, poor healing after dental work, unusual discharge from the mouth, visible bones in the mouth
  • Pain or trouble swallowing
  • Severe bone, joint, or muscle pain
  • Stomach bleeding—bloody or black, tar-like stools, vomiting blood or brown material that looks like coffee grounds

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

  • Constipation
  • Diarrhea
  • Nausea
  • Stomach pain

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of the reach of children and pets.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Throw away any unused medication after the expiration date.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.

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Note: Introduction and Additional Common Questions written and medically approved by Cleveland Clinic professionals.

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