Fosamax (alendronate) — quick, practical guide

Fosamax, whose generic name is alendronate, is a common medicine for preventing and treating osteoporosis. If your doctor prescribed it, this page tells you how to take it right, what to watch for, and simple ways to reduce risk.

How Fosamax works and who gets it

Alendronate belongs to a group called bisphosphonates. It slows bone breakdown so bone stays stronger longer. Doctors usually prescribe it for postmenopausal women with osteoporosis, men with low bone density, and people on long-term steroids that thin bones.

How to take Fosamax safely

Take Fosamax first thing in the morning on an empty stomach. Swallow the tablet whole with a full glass (6–8 oz) of plain water. Wait at least 30 minutes before eating, drinking anything other than water, or taking other meds or supplements. Stay upright (sitting or standing) for 30 minutes after taking it — lying down can cause irritation or damage to the esophagus.

Common dose patterns: 10 mg daily or 70 mg once weekly for osteoporosis treatment; 5 mg daily for prevention. If you miss a weekly dose, take it the next morning and return to your usual day. Don’t take two doses on the same day.

Don’t take Fosamax if you can’t sit/stand for 30 minutes, have certain esophagus problems, or have low blood calcium. Tell your doctor if you’re pregnant or breastfeeding.

Calcium, iron, antacids, and some supplements block absorption. Take those at least 30 minutes after Fosamax (many people wait 2 hours for extra safety).

Common mild side effects include heartburn, stomach pain, and nausea. If you get new or severe chest pain, trouble swallowing, or severe jaw pain, contact a doctor right away.

Rare but serious issues include osteonecrosis of the jaw (usually after dental surgery) and unusual thigh or groin pain from rare femur fractures. For long-term users (usually 3–5+ years), your doctor may discuss a “drug holiday” based on fracture risk.

Before starting, tell your dentist you take Fosamax — dental work sometimes needs extra planning. Your doctor may check bone density and blood calcium over time.

If cost is a concern, generic alendronate is widely available and usually inexpensive. When buying online, use licensed pharmacies and verify credentials. Never buy from sites that don’t require a prescription or that hide contact information.

Want alternatives? Risedronate or ibandronate are other bisphosphonates. For different needs, options include denosumab or bone-building drugs like teriparatide. Discuss risks and benefits with your doctor to pick the right one for you.

Questions for your doctor: Do I need calcium or vitamin D? How long should I take Fosamax? Any dental steps before starting? Keep these handy during your next visit.