Alendronate: Uses, Dosing, and Safety

Alendronate is a common drug used to treat and prevent osteoporosis in postmenopausal women and men. It belongs to a class called bisphosphonates that slow bone breakdown and help bones stay stronger. Many people know it by the brand name Fosamax, but generic alendronate is available and cheaper.

How to take it

Take alendronate first thing in the morning with a full glass of water. Swallow the tablet whole while sitting or standing. Don’t eat, drink anything else, or take other medicines for 30 minutes after you take it. This helps the pill absorb and lowers the chance of irritation to your throat and esophagus. Stay upright for 30 minutes after the dose.

Typical dosing is either 10 mg once daily or 70 mg once weekly for osteoporosis. Your doctor may change the dose based on your risk, other health conditions, and lab results. If you miss a weekly dose, take it the next morning and then return to your day. Don’t take two doses in one week to catch up without your doctor’s advice.

Side effects and precautions

Common side effects include heartburn, stomach pain, and upset stomach. A small number of people get irritation or ulcers in the esophagus. If you have trouble swallowing, new or worsening heartburn, or severe chest pain, stop the pill and call your doctor. Rare but serious risks include low blood calcium, unusual thigh bone fractures, and osteonecrosis of the jaw after dental procedures.

Before starting alendronate tell your doctor if you have low blood calcium, trouble swallowing, recent stomach surgery, or kidney problems. Alendronate is usually not advised if your kidney function is severely reduced. Also mention any current dental work; dentists may recommend completing invasive dental procedures before you begin or during treatment discuss timing carefully.

Alendronate can interact with calcium, antacids, iron, and some supplements. Take it on an empty stomach and wait 30 minutes before taking calcium, vitamin D, or other pills. Supplements are important to support bone health, but timing matters.

Doctors usually check calcium levels, vitamin D status, and repeat bone density scans to see if the medicine is working. Many people take alendronate for three to five years, then reassess fracture risk — some will take a drug holiday, others continue treatment based on age, fracture history, and bone density.

Practical tips: take alendronate on the same morning each week if you use the weekly tablet, keep a calendar reminder, and bring a list of all your medicines to appointments. If you have dental pain or plan a tooth extraction, tell both your dentist and prescriber that you use a bisphosphonate.

Urgent signs like severe jaw pain, new thigh pain, or fainting need emergency care. Keep regular follow ups, and never stop or start the drug without checking with the doctor who prescribed it today.