• Alendronate (Fosamax) for Bone Strength

    What It Is Prescribed For

    • Prevention and treatment of osteoporosis (thinning of the bones) in postmenopausal women
    • Treatment of osteoporosis in men
    • Treatment of corticosteroid-induced osteoporosis
    • Treatment of Paget's disease (thickening and softening of bones due to an abnormal increase in both bone breakdown and bone rebuilding)

    How Alendronate Works

    Rerun image Throughout life, bones are constantly being broken down and rebuilt. In the cases of osteoporosis and Paget's disease, this natural cycle is altered. This change, along with other factors, leads to a loss of bone (osteoporosis), or loss of bone at some places in the body and thickening of bone in other places (Paget's disease). Alendronate helps to improve overall bone mass by inhibiting its breakdown.

    Precautions While Using This Medicine

    See Your Doctor Regularly

    It is important that your doctor check your progress at regular visits, to allow for dosage adjustments and to help reduce side effects. The following information may affect your usage of alendronate, so be sure to tell your doctor:
    • If you are pregnant or breastfeeding
    • If you are planning to be pregnant or breastfeeding
    • If you are following a special diet
    • If you are taking aspirin, products that contain aspirin, or other nonsteroidal anti-inflammatory drugs (NSAIDs)
    • If you are taking antacids (calcium) or ranitidine

    Be Cautious With Certain Medical Conditions

    Alendronate may make some medical conditions worse. Tell your doctor if you have any medical problems, especially:
    • Stomach, intestinal, or esophageal problems
    • Kidney problems
    • Low level of blood calcium or vitamin D deficiency

    Proper Use

    Take on an Empty Stomach

    Take alendronate in the morning on an empty stomach. Take with a full glass of plain water, and wait at least 30 minutes before consuming any food, beverage, or other medicines. Food and beverages other than plain water will decrease the amount of alendronate absorbed by the body. Medicines such as antacids or calcium or vitamin supplements will also decrease absorption. Waiting at least 30 minutes allows for more of the drug to be absorbed.

    Don't Lie Down

    Do not lie down for 30 minutes after taking this drug. Staying upright will help the alendronate reach your stomach faster, and will help prevent irritation in your throat.

    Follow Dietary Recommendations

    Rerun Image You may be advised to increase the amount of calcium and vitamin D in your diet. Both of these nutrients are important for bone health. You can get these nutrients through foods, but your doctor may also recommend a supplement.
    Sources of calcium include:
    • Milk, yogurt, cheese, and other dairy products
    • Calcium-fortified juices and breakfast cereals
    • Sardines and salmon with bones
    • Leafy green vegetables, such as spinach, kale, and turnip greens
    Sources of vitamin D include:
    • Fortified milk
    • Fish oil
    • Sunshine; your body can make vitamin D with the sunlight absorbed through your skin

    Missed Dose

    Take a missed dose as soon as possible. If you miss a dose and it is almost time for the next dose, resume your usual schedule the next morning. Do not double up on doses.

    Possible Side Effects

    Check with your doctor as soon as possible if any of the following side effects occur:
    • Abdominal pain
    • Difficulty swallowing
    • Heartburn
    • Irritation or pain of the esophagus
    • Vomiting
    • Black or tarry stools
    • Skin rash or swelling (rare)
    Check with your doctor if any of the following side effects occur frequently and/or become bothersome:
    • Constipation
    • Diarrhea
    • Full or bloated feeling
    • Gas
    • Headache
    • Nausea
    • Bone, muscle, or joint pain


    Food and Drug Administration http://www.fda.gov/

    The National Institutes of Health Osteoporosis and Related Bone Diseases http://www.osteo.org/


    Canadian Family Physician http://www.cfpc.ca/

    College of Pharmacists of British Columbia http://www.bcpharmacists.org/you%5Fyour%5Fpharmacist/index.php


    Alendronate. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated June 22, 2011. Accessed December 6, 2011.

    Alendronate. EBSCO Health Library website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15&topicID=81. Published October 13, 2006. Updated October 22, 2008. Accessed December 17, 2009.

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