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Fosamax Plus D (Generic Alendronate)

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Why is this medication prescribed?

In addition to treating osteoporosis in males, alendronate is also used to treat and prevent osteoporosis in women who have undergone menopause (the “change of life,” the end of monthly cycles). Men and women who take corticosteroids (a class of drug that in some patients may cause osteoporosis) are additionally treated with alendronate for osteoporosis. Paget’s disease of the bones, which causes soft, brittle bones that are susceptible to deformation, discomfort, and readily breaking, is another ailment that is treated with alendronate. Alendronate belongs to the bisphosphonate drug class. It functions by reducing bone deterioration and boosting bone density (thickness).

How should this medicine be used?

There are three oral dosage forms of alendronate: tablets, effervescent tablets, and solutions (liquids). Typically, the solution is ingested once a week in the morning on an empty stomach. The 5-mg and 10-mg tablets are often taken once a day in the morning on an empty stomach, while the 35-mg and 70-mg tablets are typically taken once a week in the morning on an empty stomach. For six months, the 40-mg pills are typically taken once daily in the morning to treat Paget’s disease of the bones. The effervescent tablets are typically taken once a week in the morning on an empty stomach. If there is anything you do not understand about the instructions on your prescription label, contact your doctor or pharmacist to clarify it. Just as prescribed, take alendronate. Take it only as directed by your doctor, neither more nor less than that amount or more frequently.

If alendronate is not taken as directed, it might not work as intended, hurt the esophagus (the tube that connects the mouth to the stomach), or result in mouth sores. If you don’t understand, don’t think you’ll remember, or are unable to follow these directions, tell your doctor right away.

  • Alendronate must be taken as soon as you get out of bed in the morning and before you eat or drink anything. Never take alendronate right before bed or right before rising from the bed for the day.
  • Do not eat, drink, or take any other medications for at least 30 minutes after taking alendronate, including vitamins or antacids. After taking alendronate, avoid lying down for at least 30 minutes. Once you’ve had your first meal of the day and waited at least 30 minutes, 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 milliliters, 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 flavors.
  • Alendronate effervescent tablets should be dissolved in a full glass (4 ounces [120 milliliters]) 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, inform 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); chemotherapy for cancer; aspirin and other nonsteroidal anti-inflammatory medicines (NSAIDs) such ibuprofen (Advil, Ibu-Tab, Motrin, and other brands) and naproxen (Aleve, Naprelan, and other brands); or oral steroids such prednisone (Rayos), dexamethasone (Medrol), and methylprednisolone. Your physician might need to adjust the dosage of your drugs or keep a close eye on you for 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 stand or sit upright for more than 30 minutes, if your blood calcium level is low now or has ever been, if you run the danger of inhaling food or liquids, or if you have any esophageal issues. You can be advised by your doctor not to take alendronate.
  • If using the effervescent tablets, inform your doctor if you are receiving radiation treatment or if you are following a sodium-restricted diet; Additionally, if you currently have or ever had any of the following conditions: anemia (condition in which the red blood cells do not carry enough oxygen to all the parts of the body); low vitamin D levels; difficulty swallowing; heartburn; ulcers or other stomach issues; cancer; any type of infection, particularly in the mouth; issues with your mouth, teeth, or gums; any condition that prevents your blood from clotting normally; dental or kidney disease.
  • 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.
  • It’s important to be aware that alendronate can lead to osteonecrosis of the jaw (ONJ), a dangerous disorder of the jaw bone, particularly if you have dental care while taking the drug. Before you begin taking alendronate, a dentist should inspect your teeth and carry out any necessary procedures, such as cleaning or repairing ill-fitting dentures. While using alendronate, be sure to brush your teeth and care for your mouth. Before getting any dental work done while taking this medication, see your doctor.
  • 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 the pain might go away if you do so.
  • Consult your doctor about further measures you can take to stop osteoporosis from arising or getting worse. Most likely, your doctor will advise you to quit smoking, limit your alcohol intake, and engage in regular weight-bearing activity.

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
  • Edema 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 ache
  • Vomit that is bloody or resembles coffee grounds
  • Bloody, dark, or tarry stools
  • Fever
  • Flaking or blistering skin
  • Rash (which sunlight may aggravate)
  • Itching
  • Hives
  • Enlargement of the throat, lips, tongue, eyes, or face
  • Having trouble breathing
  • Hoarseness
  • Throbbing or painful gums
  • Teeth slipping out of place
  • Jaw tingling or feeling heavy
  • Jaw healing problems
  • Eye discomfort
  • Groin, thighs, or hips: dull, aching ache

Alendronate, a bisphosphonate drug used to treat osteoporosis, may raise your chance of breaking your thigh bone or bones in your thigh. Before the bone(s) break, you may suffer discomfort in your hips, groin, 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 program online at or by phone at 1-800-332-1088 if you have a serious side event.

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. Keep it at room temperature and out of the bathroom and other places with excessive heat and moisture. 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, utilizing a medicine take-back program is the easiest approach to get rid of your medication. To find out about take-back programs 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 program, 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 dial 1-800-222-1222 to contact your local poison control center. Dial 911 to reach the nearest emergency services if the sufferer has collapsed or has stopped breathing. Never let the victim lie down, and never try to make them throw up.

Overdose signs could include the following:

  • Heartburn
  • Nausea
  • Abdominal pain
  • Vomit that is bloody or resembles coffee grounds
  • Swallowing issues or swallowing discomfort
  • Feces that is bloody 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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