Head-to-head comparisons of medication uses, side effects, warnings, and more.
Key takeaways
Alendronate (Fosamax) and estradiol (Estrace) are both medications that can be used to improve bone health, but they belong to different classes and have different uses. Alendronate is a bisphosphonate that prevents and treats osteoporosis by slowing bone breakdown. Estradiol, on the other hand, is an estrogen replacement used to relieve menopausal symptoms like vaginal dryness and itching and also to prevent bone loss after menopause. Alendronate is taken orally, either daily or weekly, and is available in tablet, oral solution, and dissolvable tablet forms. Estradiol comes as an oral tablet and cream, although the cream is not approved to prevent bone loss after menopause. Common side effects of alendronate include stomach pain and heartburn, whereas estradiol can cause nausea and breast pain and increase the risk of certain cancers and blood clots. Alendronate requires you to stay upright for 30 minutes after taking it. Both medications are available as a lower-cost generic.
Alendronate (Fosamax)
Estradiol tablet
Alendronate (Fosamax)
Estradiol tablet
Summary of Fosamax vs. Estrace
Summary for Bisphosphonate
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.
Summary for Estrogen replacement
Prescription only
Estradiol tablet is an estrogen hormone used to treat menopause symptoms like hot flashes, night sweats, and vaginal irritation. It also helps prevent bone loss (osteoporosis) after menopause. Though not as common, it's also FDA approved to treat certain advanced stages of breast and prostate cancer. The dose depends on your condition, but tablets are typically taken by mouth 1 to 3 times a day. Common side effects include nausea, vomiting, headache, and breast pain.
Indications of Fosamax vs. Estrace
Indications for
•Prevention and treatment of osteoporosis in females