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Fosamax vs. Forteo

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

Key takeaways

Alendronate (Fosamax) and teriparatide (Forteo) are both used to treat osteoporosis, but they work in different ways and have different forms of administration. Alendronate (Fosamax) is a bisphosphonate that you take orally, either daily or weekly, and it works by slowing down bone breakdown. In contrast, teriparatide (Forteo) is a parathyroid hormone analog that you inject under the skin once a day, and it helps build new bone. Alendronate (Fosamax) and teriparatide (Forteo) are both available in generic and brand forms. Alendronate (Fosamax) can cause stomach-related side effects and requires you to stay upright for 30 minutes after taking it, whereas teriparatide (Forteo) can cause dizziness and must be stored in the refrigerator. Additionally, you can only use teriparatide (Forteo) for up to 2 years due to a potential risk of bone cancer, while alendronate (Fosamax) can be used for longer periods, depending on your condition and doctor's advice.

Alendronate

(Fosamax)

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Forteo

(teriparatide)

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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 Forteo

Prescription only

Forteo (teriparatide) is used to treat osteoporosis (bone loss or weakening). It's for people who are at very high fracture risk or people who've already tried other osteoporosis medications. Forteo (teriparatide) is an injection that you give to yourself once a day. Some common side effects include general body pain and joint pain. This medication comes as a prefilled pen, but it doesn't come with pen needles. Forteo (teriparatide) is only available as a brand medication; there's no generic version yet.

Indications for Forteo

Pros and Cons for Forteo

Pros

  • Can use if you're unable to take or still getting fractures with other osteoporosis medications
  • A first-choice option for people at very high fracture risk (have had a fracture caused by osteoporosis before or have many risk factors for fracture)
  • Lowers the risk for back fractures and fractures in other parts of the body (not including the hip) in postmenopausal women with osteoporosis

Cons

  • Not a first-choice option for most people with osteoporosis
  • Only available as an injection under the skin
  • Can only use for a total of 2 years throughout your entire life because of unclear risk for bone cancer with longer treatment

Common Side Effects for Forteo

  • Body pain (21%)
  • Joint pain (10%)
  • Runny nose (10%)
  • Nausea (9%)
  • Body weakness (9%)
  • Headache (8%)
  • Dizziness (8%)
  • High blood pressure (7%)

Warnings for Forteo

  • Bone cancer (osteosarcoma)
  • High calcium levels in the blood
  • Kidney stones
  • Low blood pressure
  • Higher risk of side effects from digoxin (Lanoxin)

Prices with our coupons for Fosamax vs. Forteo

Price Card Drug Icon
Alendronate3 dose packs / 4 tablets of 70mg
$16.67$112.89
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Teriparatide (Forteo)1 pen / of 20mcg/dose
$1,035.37$3,077.25
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