alendronate
Alendronate sodium (Fosamax) is a bisphosphonate that prevents and treats osteoporosis. It works by slowing the breakdown of bones so that the body has a chance to build up more bone; this strengthens bones and lowers the risk of fractures. Alendronate (Fosamax) is taken by mouth, either daily or weekly dosing, depending on your dose. In addition to the tablet, it's also available as an oral solution and a dissolvable tablet (brand name Binosto). Some common side effects of alendronate (Fosamax) can include stomach pain, heartburn, and bone or muscle pain.
What is Alendronate (Fosamax)?
What is Alendronate (Fosamax) used for?
Prevention and treatment of osteoporosis in females
Treatment of osteoporosis in males
How Alendronate (Fosamax) works
Alendronate (Fosamax) is a bisphosphonate. It attaches to bones to prevent bone breakdown, lowering the risk of fractures.
Drug Facts
More on Alendronate (Fosamax) essentials
Get your GoodRx coupon
What are the side effects of Alendronate (Fosamax)?
Common Side Effects
- Stomach pain (up to 7%)
- Muscle, bone, and joint pain (up to 4%)
- Heartburn or indigestion (up to 4%)
- Nausea (up to 4%)
- Passing gas (up to 4%, more common with daily dose)
Other Side Effects
- Bloating
- Constipation
- Headache
- Diarrhea
- Ulcers in the esophagus
Serious Side Effects
- Allergic reactions: trouble breathing, hives, swelling of your face, lips, tongue, or throat
- Low calcium levels
Source: DailyMed
More on Alendronate (Fosamax) side effects
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Stomach pain
Rare
Skin rash
Incidence not known
Blistering, peeling, or loosening of the skin
bloating or swelling of the face, arms, hands, lower legs, or feet
bone, joint, or muscle pain, severe and occasionally incapacitating
chills
confusion
convulsions
difficulty with breathing
difficulty with moving
heavy jaw feeling
hives or welts
irregular heartbeats
joint pain
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
loosening of a tooth
muscle aching or cramping
muscle cramps in the hands, arms, feet, legs, or face
numbness and tingling around the mouth, fingertips, or feet
pain or burning in the throat
pain, swelling, or numbness in the mouth or jaw
rapid weight gain
red skin lesions, often with a purple center
red, irritated eyes
redness of the skin
sores, ulcers, or white spots on the lips or tongue or inside the mouth
stomach cramps
swollen joints
tingling of the hands or feet
trouble breathing
unusual tiredness or weakness
unusual weight gain or loss
vomiting
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Alendronate (Fosamax)
Pros
Can be taken by males and females (unlike another bisphosphonate)
Option for daily or weekly dosing for osteoporosis
Taken by mouth
Comes as a regular tablet, oral solution, or effervescent tablet
Cons
Can't lie down for 30 minutes after you take it
Must take on empty stomach, can't eat for 30 minutes after a dose
Can cause serious jaw problems and severe muscle or joint pain
Has many stomach-related side effects
Pharmacist tips for Alendronate (Fosamax)
Take alendronate (Fosamax) first thing in the morning with a full glass (6 to 8 ounces) of plain water. If you take the oral solution version of this medication, you only need to drink 2 ounces of water (1/4 cup) after your dose.
Avoid eating, drinking, or taking other medications for 30 minutes after taking alendronate (Fosamax). Medications, food, and beverages other than water can prevent your body from absorbing alendronate (Fosamax).
If you take Binosto, the effervescent tablet version of alendronate (Fosamax), dissolve the tablet in 4 ounces (1/2 cup) of plain, room temperature water. Wait 5 minutes after the solution stops fizzing, stir the solution for 10 seconds, and then drink. Never try to swallow, chew, or suck on Binosto because doing so can cause damage to your mouth or throat.
After taking your dose of alendronate (Fosamax), be sure to stay upright for at least 30 minutes AND until after you eat your first food of the day. This will prevent the medication from harming your esophagus, the tube connecting your mouth and your stomach.
Your provider might prescribe calcium supplements for you to take along with alendronate (Fosamax). Don't take alendronate (Fosamax) and calcium supplements at the same time because calcium can stop your body from absorbing alendronate (Fosamax). Take calcium at least 30 minutes after your alendronate (Fosamax) dose.
Let your provider know if you have any major dental procedures coming up. They might have you temporarily stop taking alendronate (Fosamax) to lower your risk of jaw problems.
If you're on a low-salt diet, Binosto might not be the best option for you. Each tablet contains a high amount of salt, which could make certain conditions (e.g., heart failure, high blood pressure) worse.
More on Alendronate (Fosamax) tips
Frequently asked questions about Alendronate (Fosamax)
How to save using GoodRx
What are the risks and warnings for Alendronate (Fosamax)?
Alendronate (Fosamax) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Irritation and ulcers of the stomach and esophagus
Risk factors: Taking other medications that can irritate the stomach | Ulcers or problems with the stomach or esophagus | Trouble swallowing | Problems sitting or standing for at least 30 minutes
Alendronate (Fosamax) can irritate and cause ulcers in the stomach and esophagus. You should take this medication with 6-8 ounces of water followed by standing and sitting upright for 30 minutes after your dose to lower your risk of this side effect. Tell your healthcare provider if staying upright for this long is difficult for you. There might be better alternative medications for you. If you do start taking alendronate (Fosamax), make sure you tell your provider if you notice new pain while swallowing or heartburn, these might be symptoms of stomach ulcers.
Lower calcium levels
Risk factors: Current low calcium levels | Low vitamin D levels | Paget's disease | People taking steroid medications like prednisone
If you have low blood calcium levels and low vitamin D levels, they need to be treated before you can start taking alendronate (Fosamax), since this medication can make your calcium levels drop even lower. Make sure you take any calcium and vitamin D supplements recommended by your healthcare provider, and be sure to get any ordered blood tests done on time. Let your provider know if you notice new or different muscle spasms or twitching; these can be symptoms of low calcium levels.
Muscle Pain
Risk factors: Postmenopausal women
It's rare, but some people who take alendronate (Fosamax) develop severe bone, muscle, or joint pain. It can happen days to months after starting the medication. Females who've gone through menopause are more likely to experience this side effect. Talk to your healthcare provider if this happens to you. Most times, the pain goes away after you stop taking alendronate (Fosamax).
Jaw bone problems
Risk factors: Oral or dental surgery | Cancer | Taking certain medications that weaken your immune system like chemotherapy or steroids | Poor oral hygiene | Current problems with your teeth, jaw, or blood cells | Anemia | Dentures that don't fit correctly | Infection of the mouth, teeth, or jaw | Using alendronate (Fosamax) for a long time
Alendronate (Fosamax) can harm the jaw bone. This is very rare and is more likely to happen if you have major dental surgery, poor oral hygiene, cancer, take alendronate (Fosamax) for a long time, or take certain other medications. Make sure your provider knows about any upcoming dental procedures, and make sure your dentist and any oral surgeons know you are taking alendronate (Fosamax). Talk to your provider if you notice pain, swelling, or an infection in your mouth or jaw.
Leg bone fractures
Risk factors: People taking steroid medications
It's rare, but some people taking alendronate (Fosamax) have had unusual fractures in their legs that happen with little or no force. Scientists aren't sure if these are caused by the medication, since people with osteoporosis who don't take alendronate (Fosamax) also get these fractures. Many of those who've experienced these types of fractures were also taking steroid medications when it happened. Let your provider know if you notice a new dull or aching pain in your hips or thighs while taking alendronate (Fosamax).
Not recommended in people with serious kidney problems
Alendronate (Fosamax) can't be taken by people with serious kidney problems. If you've kidney problems, ask your provider if alendronate (Fosamax) is appropriate for you.
Alendronate (Fosamax) dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 4 bottles of 75ml of 70mg/75ml | 1 carton | $46.65 | $46.65 |
Typical dosing for Alendronate (Fosamax)
Alendronate (Fosamax) tablets
Treatment of osteoporosis in males and postmenopausal females:
The typical dose is to take 70 mg by mouth once a week, OR to take 10 mg by mouth once a day.
Prevention of osteoporosis in postmenopausal females:
The typical dose is to take 35 mg by mouth once a week, OR to take 5 mg once a day.
Treatment of osteoporosis caused by steroids:
The typical dose is to take 5 mg by mouth once a day. For postmenopausal females not receiving estrogen, the typical dose is 10 mg once a day.
Paget's disease:
The typical dose is 40 mg by mouth once a day for 6 months.
Binosto (alendronate) effervescent tablet and alendronate oral solution
Treatment of osteoporosis in males and postmenopausal females:
The typical dose is to take 70 mg by mouth once a week. Binosto tablets must first be dissolved in 4 ounces of room temperature water before you drink the medication.
More on Alendronate (Fosamax) dosage forms
Interactions between Alendronate (Fosamax) and other drugs
More on Alendronate (Fosamax) interactions
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Parathyroid Hormone
How much does Alendronate (Fosamax) cost?
Alendronate (Fosamax) contraindications
Problems in the throat or gut that slows the passing of food through the gut
Not able to stand or sit upright for at least 30 minutes
Hypocalcemia (low calcium levels)
What are alternatives to Alendronate (Fosamax)?
Prevention and treatment of osteoporosis in females
Treatment of osteoporosis in males
Osteoporosis in women who have gone through menopause (postmenopause)
Osteoporosis in men
Osteoporosis caused by long-term corticosteroid use
Paget's disease
Osteoporosis in women who have gone through menopause (postmenopause)
What is the latest news about Alendronate (Fosamax)?
Alendronate (Fosamax) images
Get savings updates for Alendronate (Fosamax)
Receive price alerts, news, and other messages from GoodRx about Alendronate (Fosamax) and other healthcare topics and relevant savings offers.By providing your email, you consent to receive marketing communications from GoodRx, which may include content and/or data related to men’s health, women's health, reproductive care, or sexual health. You agree to the GoodRx Terms of Use and acknowledge the Privacy Policy. You can unsubscribe at any time.
References
Best studies we foundANI Pharmaceuticals, Inc. (2023). Alendronate sodium solution [package insert]. DailyMed.
ASCEND Therapeutics. (2023). Binosto- alendronate sodium tablet, effervescent [package insert]. DailyMed.
Black, D. M., et al. (2006). Effects of continuing or stopping alendronate after 5 years of treatment. Journal of the American Medical Association.
Hangzhou Minsheng Binjiang Pharmaceutical Co., Ltd. (2023). Alendronate- alendronate sodium tablet [package insert]. DailyMed.
National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2022). Paget’s disease of bone.
Schnitzer, T. J. (2001). Update on alendronate for osteoporosis: Once-weekly dosing. Expert Opinion on Pharmacotherapy.
Simon, J. A., et al. (2002). Patient preference for once-weekly alendronate 70 mg versus once-daily alendronate 10 mg: A multicenter, randomized, open-label, crossover study. Clinical Therapeutics.
U.S. Food and Drug Administration. (2018). FDA Drug Safety Communication: Safety update for osteoporosis drugs, bisphosphonates, and atypical fractures.
Browse medications
View AllResearch prescriptions and over-the-counter medications from A to Z, compare drug prices, and start saving.