Are you a healthcare professional? Join GoodRx for HCPs

Compare Fosamax vs. Prolia

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

Key takeaways

Alendronate (Fosamax) and Prolia (denosumab) are both used to treat osteoporosis, but they work differently and are taken in different ways. Alendronate (Fosamax) is a bisphosphonate that you take by mouth, either daily or weekly, and it helps by slowing down bone breakdown. Prolia (denosumab), on the other hand, is a monoclonal antibody given as an injection under the skin every six months by a healthcare professional. While alendronate (Fosamax) can cause stomach pain and heartburn, Prolia (denosumab) can lead to low calcium levels and back pain. Alendronate (Fosamax) requires you to stay upright for 30 minutes after taking it, whereas using Prolia (denosumab) requires that you take calcium and vitamin D supplements daily. Both medications can cause serious jaw problems, but Prolia (denosumab) has a higher risk of causing infections.

Alendronate (Fosamax)
Prolia (denosumab)
Alendronate (Fosamax)
Prolia (denosumab)
Summary of Fosamax vs. Prolia
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 Monoclonal antibody
Prescription only
Prolia (denosumab) is an injection that's used to treat osteoporosis in adults at high risk of fracture. It's also for those at high risk of fractures from certain cancer medications. It works as a monoclonal antibody called a RANKL inhibitor to strengthen your bones. Prolia (denosumab) is a convenient option because you only need an injection every 6 months. It's injected under the skin by a healthcare professional at a medical office. Side effects include back and muscle pain. It also has a risk of causing dangerously low calcium levels.
Indications of Fosamax vs. Prolia
Indications for

•Prevention and treatment of osteoporosis in females

•Treatment of osteoporosis in males

•Paget's disease

Indications for

•Osteoporosis in women who've gone through menopause and at high risk of fracture

•Osteoporosis in men at high risk of fracture

•Osteoporosis caused by steroid medications in people at high risk of fracture

•Bone loss in men at high risk of fracture taking certain medications for prostate cancer

•Bone loss in women at high risk of fracture taking certain breast cancer medications
Pros and Cons of Fosamax vs. Prolia
Pros and Const for Bisphosphonate
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

Pros and Const for Monoclonal antibody
Pros

•Works well at preventing bone loss, which lowers your risk of breaking a bone

•Only given once every 6 months, which is less often than most other osteoporosis medications

•An alternative option for people who can't take bisphosphonates like alendronate (Fosamax)

•A good option for postmenopausal women at very high risk of fractures

Cons

•Must go to the medical office to get the injection

•Must take with calcium and vitamin D supplements

•Can cause bone and muscle pain

•Not safe during pregnancy
Common Side Effects of Fosamax vs. Prolia
Common Side Effects for

•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)

Common Side Effects for

•Back pain (35%)

•Pain in the arm or leg (12%)

•Muscle, bone, or joint pain (up to 8%)

•High cholesterol levels (7%)

•Pain or discomfort while urinating and other symptoms of a bladder infection (6%)

•Sensation that the room is spinning (5%)

•Swelling in the hands or feet (5%)

•Upper respiratory tract infection (5%)
Warnings of Fosamax vs. Prolia
Common Side Effects for

•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

Common Side Effects for

•Dangerously low calcium levels

•Risk of fractures in the thigh bone

•Risk of spine fractures after stopping Prolia (denosumab)

•Risk of serious infections

•Risk of problems in the jawbone

•Serious allergic reactions and skin reactions

•Severe bone, muscle, or joint pain

•Don't take with Xgeva (denosumab)
Prices with our coupons for Fosamax vs. Prolia
Learn more about Alendronate
Learn more about Prolia

Browse medications

View All

Research prescriptions and over-the-counter medications from A to Z, compare drug prices, and start saving.

Compare Fosamax vs. Prolia

Key takeaways

Summary of Fosamax vs. Prolia

Indications of Fosamax vs. Prolia

Pros and Cons of Fosamax vs. Prolia

Common Side Effects of Fosamax vs. Prolia

Warnings of Fosamax vs. Prolia

Prices with our coupons for Fosamax vs. Prolia

Compare other Osteoporosis drugs

Browse medications

Good news for your inbox