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Why is this medication prescribed?

Alendronate is used to treat and prevent osteoporosis in men and women who have experienced menopause (the “change of life,” the end of monthly periods), a condition in which the bones become thin, weak, and easily break. In both men and women using corticosteroids, alendronate is used to treat osteoporosis (a type of medication that may cause osteoporosis in some patients). Additionally, Paget’s disease of the bones is treated with alendronate (a condition in which the bones are soft and weak and may be deformed, painful, or easily broken). Alendronate belongs to the group of drugs known as bisphosphonates. By halting bone deterioration and boosting bone density, it functions (thickness).

How should this medicine be used?

The oral forms of alendronate include tablets, effervescent tablets, and solutions (liquids). Once a week in the morning, the solution is typically given on an empty stomach. The 5-mg and 10-mg pills should typically be taken on an empty stomach once daily in the morning, while the 35-mg and 70-mg tablets should typically be taken on an empty stomach once every other week in the morning. To treat Paget’s disease of the bones, the 40-mg tablets are typically given once daily in the morning for six months. Once a week in the morning, the effervescent tablets are typically taken on an empty stomach. Ask your doctor or pharmacist to explain any instructions on your prescription label that you are unsure about following. Follow the medication’s directions precisely. Never take it in larger or less amounts or more frequently than directed by your doctor.

If alendronate is not taken in accordance with the suggested dosage, it may not work as intended, create mouth sores, or harm the oesophagus (the tube that connects the mouth to the stomach). If you do not understand, do not believe you will remember, or are unable to follow these directions, please tell your doctor.

  • Before you eat or drink anything, you must take alendronate as soon as you get out of bed in the morning. Never take alendronate before going to sleep or right before getting out of bed for the day.
  • Do not eat, drink, or take any other drugs (including vitamins or antacids) for at least 30 minutes after taking alendronate. For at least 30 minutes after taking alendronate, avoid lying down. Until you’ve consumed your first meal of the day and at least 30 minutes have passed, sit or stand straight.
  • If you’re taking alendronate pills, you should swallow them with a full glass of water (6 to 8 ounces [180 to 240 mL]). Alendronate pills should never be used with anything other than plain water. This includes tea, coffee, juice, milk, sparkling water, mineral water, and coffee. Do not split, chew, or crush the tablets; instead, swallow them whole. Avoid sucking on the tablets.
  • Drink at least 2 ounces (60 millilitres, or 1/4 cup) of water after taking alendronate oral solution if you’re taking it. Never mix alendronate solution with anything other than plain water, including tea, coffee, juice, milk, mineral water, sparkling water, and beverages with flavours.
  • Alendronate effervescent tablets should be dissolved in a full glass (4 ounces [120 millilitres]) of normal, non-carbonated water before consumption if you’re taking them. Never dissolve alendronate effervescent tablets in anything other than plain water, including tea, coffee, juice, milk, mineral water, sparkling water, or sparkling wine. When the effervescence ends, wait at least five minutes before drinking the fluid. Avoid chewing, sucking, and swallowing the effervescent tablets.

Alendronate regulates Paget’s disease of the bones and osteoporosis but does not treat either illness. Your bone density may not start to rise for three months or more. Only when taken consistently does alendronate aid in osteoporosis treatment and prevention. Alendronate should still be used even if you feel OK. Do not discontinue taking alendronate without consulting your doctor, but periodically discuss with them if you still require alendronate.

For a copy of the manufacturer’s information for the patient, ask your pharmacist or doctor.

Other uses for this medicine

Ask your doctor or pharmacist for more details if you believe this drug should be used for something else.

What special precautions should I follow?

Before taking alendronate,

  • If you have an allergy to alendronate or any other drug, tell your doctor and pharmacist very away.
  • Inform your doctor and pharmacist about any vitamins, nutritional supplements, herbal items, and prescription and over-the-counter medicines you are now taking or intend to take. Any of the following should be mentioned: angiogenesis inhibitors such as sunitinib (Sutent), pazopanib (Votrient), sorafenib (Nexavar), or everolimus (Afinitor, Zortress); aspirin, nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen (Advil, Ibu-Tab, Motrin, etc.) and naproxen (Aleve, Naprelan, Naprosyn, etc.); chemotherapy for cancer; or oral steroids such dexamethasone, methylprednisolone (Medrol), and prednisone (Rayos). Your doctor might need to adjust your medication doses or keep a close eye out for any negative side effects.
  • Take any additional drugs, such as dietary supplements, vitamins, or antacids, at least 30 minutes after taking alendronate.
  • Inform your doctor if you are unable to sit or stand upright for more than 30 minutes, if your blood calcium level is low or has ever been low, if you run the danger of inhaling food or liquids into your lungs, or if you have any esophageal issues. Your doctor might advise against taking alendronate.
  • If using the effervescent tablets, inform your doctor if you have cancer, any type of infection, especially in your mouth, issues with your teeth or gums, are undergoing radiation therapy, are on a sodium-restricted diet, have difficulty swallowing, experience heartburn, have ulcers or other stomach issues, are currently taking any medications, or have ever taken any of the foregoing conditions.
  • Inform your doctor if you are expecting or nursing a baby. Additionally, let your doctor know if you intend to conceive in the future because alendronate may stay in your system for years after you stop taking it. If you find out you’re pregnant during or after treatment, call your doctor right away.
  • The risk of osteonecrosis of the jaw (ONJ), a dangerous disorder of the jaw bone, is something you should be aware of if you take alendronate and undergo dental surgery or therapy. Before you begin taking alendronate, get your teeth checked by a dentist and have any necessary procedures, such as cleaning or repairing ill-fitting dentures, performed. While using alendronate, remember to brush your teeth and take care of your oral hygiene. If you plan to have any dental procedures while taking this medication, see your doctor first.
  • Alendronate may induce excruciating joint, muscle, or bone pain, so be aware of this. After taking alendronate for the first time, you can experience this pain days, months, or even years later. It’s crucial that you and your doctor are aware that alendronate may be the source of this type of discomfort, even though it may start after you’ve taken the medication for a while. If you ever suffer significant pain while receiving alendronate treatment, call your doctor straight once. The doctor might advise you to stop taking alendronate, and your pain might go away if you do so.
  • Discuss further measures you can take to stop osteoporosis from arising or getting worse with your doctor. Your doctor would likely advise you to refrain from smoking and consuming significant amounts of alcohol, as well as to engage in regular weight-bearing exercise.

What special dietary instructions should I follow?

While taking alendronate, you should consume a lot of calcium- and vitamin D-rich foods and beverages. Your doctor will advise you on the best foods and beverages to consume in order to get the recommended daily servings of these nutrients. Inform your doctor if you have trouble consuming enough of these items. In that situation, your doctor may suggest or prescribe a supplement.

What should I do if I forget a dose?

Do not take a missed dose of once-daily alendronate at a later time in the day. Take one pill as usual the next morning and skip the missed dose. To make up for a missing dose, do not take a second one.

Alendronate is taken once a week; if you miss a dosage, take it the next morning. Then go back to taking one dose on the day you usually do each week. Never take two doses in one day, and never take two doses to make up for a missing one.

What side effects can this medication cause?

Alendronate might have negative effects. If any of these symptoms are severe or do not go away, let your doctor know right once:

  • Nausea
  • Abdominal pain
  • Constipation
  • Diarrhea
  • Gas
  • Stomach bloating or feeling full
  • Alterations in food taste
  • Headache
  • Dizziness
  • Swelling in the hands, legs, or joints
  • Cramps, twitches, or spasms of the muscles

Some adverse effects can be very harmful. Call your doctor right away before taking any more alendronate if you have any of the following symptoms or those mentioned in the SPECIAL PRECAUTIONS section:

  • New or escalating heartburn
  • Having trouble swallowing
  • Difficulty swallowing
  • Chest pain
  • Vomit that is bloody or resembles coffee grounds
  • Bloody, dark, or tarry stools
  • Fever
  • Peeling or blistering skin
  • Rash (may be made worse by sunlight)
  • Itching
  • Hives
  • Eye, face, lip, tongue, or throat swelling
  • Having trouble breathing
  • Hoarseness
  • Bruised or painful gums
  • Tooth sensitivity
  • Jaw tingling or feeling heavy
  • Jaw healing is not very good
  • Eye discomfort
  • Hips, thighs, or groyne: dull, aching ache


Alendronate, a bisphosphonate drug used to treat osteoporosis, may raise your chance of breaking your thigh bone (s). Before the bone(s) break, you may suffer discomfort in your hips, groyne, or thighs for a few weeks or months. You may also discover that one or both of your thigh bones have broken even though you haven’t fallen or been in any other kind of accident. In healthy individuals, it is uncommon for the thigh bone to break, however individuals with osteoporosis may still break this bone even if they do not take alendronate. The dangers of using alendronate should be discussed with your doctor.

Other negative effects of alendronate are possible. If you experience any strange issues while taking this medicine, contact your doctor right away.

You or your doctor can submit a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting programme online or by phone if you have a serious side event (1-800-332-1088).

What should I know about storage and disposal of this medication?

Keep this medication tightly closed in the original container and out of the reach of children. Store it away from excessive heat and moisture at room temperature (not in the bathroom). Keep alendronate solution from freezing.

As many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and are simple for young children to open, it is crucial to keep all medications out of sight and out of reach of children. Always lock safety caps and promptly stash medication up and away from young children where it is out of their sight and reach to prevent poisoning.

Unused prescriptions must be disposed of carefully to prevent pets, kids, and other people from ingesting them. You should not, however, dispose of this medication in the toilet. Instead, utilising a medicine take-back programme is the easiest approach to get rid of your medication. To find out about take-back programmes in your area, speak with your pharmacist or the garbage/recycling department in your city. If you do not have access to a take-back programme, see the FDA’s Safe Disposal of Medicines website at for additional information.

In case of emergency/overdose

Give the victim a full glass of milk in the event of an overdose, and then phone 1-800-222-1222 for the poison control centre in your area. Call local emergency services at 911 if the person is unresponsive or has collapsed. Allowing the victim to lie down or attempting to induce vomiting are both unacceptable.

Overdose signs could include the following:

  • Heartburn
  • Nausea
  • Abdominal pain
  • Vomit that is bloody or resembles coffee grounds
  • Swallowing problems or swallowing pain
  • Stools that are red or dark and tarry

What other information should I know?

Keep all of your appointments with your physician and the lab. To monitor how your body is responding to alendronate, your doctor may request specific lab tests.

No one else should take your medication. Any queries you may have regarding medication refills should be directed to your pharmacist.

You should keep a written record of every medication you take, including any over-the-counter (OTC) items, prescription drugs, and dietary supplements like vitamins and minerals. This list should be brought with you whenever you see a doctor or are admitted to the hospital. You should always have this information with you in case of emergencies.

Brand names

  • Binosto®
  • Fosamax®
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