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Prolia vs. Alendronate

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

Prolia

(denosumab)

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Alendronate

(Fosamax)

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Summary for Prolia

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 for Prolia

Pros and Cons for Prolia

Pros

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 for Prolia

Warnings for Prolia

  • 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)

Summary for Alendronate

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 Alendronate

Pros and Cons for Alendronate

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 Alendronate

  • 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 Alendronate

  • 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

Prices with our coupons for Prolia vs. Alendronate

Price Card Drug Icon
Prolia1 syringe / 1ml of 60mg/ml
$1,824.75$2,487.17
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Alendronate3 dose packs / 4 tablets of 70mg
$17.08$79.08
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