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Fosamax vs. Actonel

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Alendronate (Fosamax) and risedronate (Actonel) are both bisphosphonates used to treat and prevent osteoporosis. Alendronate is available in multiple forms, including tablets, oral solutions, and effervescent tablets, and can be taken daily or weekly. Risedronate also offers various dosing options, including daily, weekly, and monthly, and has a delayed-release form called Atelvia, which is taken after breakfast. Alendronate must be taken on an empty stomach, while Atelvia can be taken with food, which may reduce stomach pain. Both medications can cause serious side effects like jaw problems and stomach irritation, but risedronate has a higher incidence of common side effects such as infections and back pain. Additionally, both medications are not recommended for people with severe kidney disease.

Alendronate

(Fosamax)

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Risedronate

(Actonel)

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Summary for Fosamax

Prescription only

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.

Indications for Fosamax

Pros and Cons for Fosamax

Pros

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

Common Side Effects for Fosamax

  • 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)

Warnings for Fosamax

  • Irritation and ulcers of the stomach and esophagus
  • Lower calcium levels
  • Muscle Pain
  • Jaw bone problems
  • Leg bone fractures
  • Not recommended in people with serious kidney problems

Summary for Actonel

Prescription only

Risedronate (Actonel) is a first-choice medication used to treat osteoporosis (bone loss or weakening). It can help improve bone mineral density (BMD) and lower the risk of bone fractures. There are several dosing options and a delayed-release form in case a particular dosing schedule is more convenient for some people.

Indications for Actonel

  • Osteoporosis in women who have gone through menopause (postmenopause)
  • Osteoporosis in men
  • Osteoporosis caused by long-term corticosteroid use
  • Paget's disease

Pros and Cons for Actonel

Pros

  • Can be used for many types of osteoporosis
  • Many available dosing options (daily, weekly, monthly) for postmenopausal women
  • Also comes as a delayed-released form that's taken after breakfast for postmenopausal women
  • Available in a lower-cost generic form

Cons

  • Risk of many side effects, including stomach pain and severe jaw problems
  • Not recommended for people with severe kidney disease

Common Side Effects for Actonel

Note: For once-daily dosing

  • Infection (31%)
  • Back pain (28%)
  • Joint pain (24%)
  • Constipation (13%)
  • Stomach pain (12%)
  • Heartburn (11%)
  • Nausea (11%)
  • Diarrhea (11%)
  • Flu-like symptoms (11%)
  • Urinary tract infection (11%)
  • Arthritis (10%)
  • Headache (10%)
  • Bronchitis (10%)

Warnings for Actonel

  • Stomach and esophagus irritation and ulcers
  • Breakdown of the jawbone (osteonecrosis)
  • Severe bone, joint, or muscle pain
  • Leg bone fractures
  • Low calcium in the blood

Prices with our coupons for Fosamax vs. Actonel

Price Card Drug Icon
Alendronate3 dose packs / 4 tablets of 70mg
$14.80$25.04
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Risedronate3 dose packs / 1 tablet of 150mg
$47.14$483.05
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