Alendronate oral tablet side effects: A detailed guide

This article describes possible side effects of alendronate oral tablet. You can explore this overview article to learn more about alendronate, including the drug’s uses, ways to save on cost, and more.

Alendronate oral tablet is a generic version of the brand-name drug Fosamax. Alendronate also comes in a liquid solution that you swallow, but this form isn’t described in this article. To learn more about this form, talk with your doctor.

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More common side effects of alendronate

Alendronate oral tablet may cause mild or serious side effects. Below are some of the more common side effects of this medication.

Commonly reported side effects of alendronate oral tablet include:

• abdominal pain
• acid reflux
• constipation
• diarrhea
• indigestion

Mild side effects of alendronate

Alendronate may cause certain mild side effects. Most often, mild side effects are temporary and can be easily managed. Tell your doctor or pharmacist if you have side effects that don’t go away or become bothersome.

Mild side effects of alendronate oral tablet that occurred in studies include:

• abdominal pain
• acid reflux
• bone, joint, or muscle pain
• changes in taste
• constipation
• diarrhea
• difficulty swallowing
• dizziness
• flatulence
• headache
• indigestion
• muscle cramps
• nausea
• vomiting
• mild allergic reaction*†

Alendronate oral tablet may cause more mild side effects than those listed above. For details, see the drug’s prescribing information.

* To learn more about this side effect, see the “Side effects of alendronate in detail” section below.
† An allergic reaction is possible with alendronate oral tablet. It wasn’t reported in the drug’s studies, but has happened since alendronate was approved for use.

Serious side effects of alendronate

Alendronate may cause certain serious side effects. If you have any serious side effects from alendronate oral tablet, call your doctor right away. But if you think you’re having a medical emergency or your side effects feel life threatening, take immediate action. Call 911 or a local emergency number, or go to the nearest emergency room.

After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Visit MedWatch’s website if you’d like to notify the FDA about a side effect you’ve had with alendronate.

Serious side effects of alendronate oral tablet that occurred in studies include:

• hypocalcemia (low blood calcium)
• severe bone, joint, or muscle pain
• death of tissue in the jaw bone*
• side effects in the esophagus*
• unusual bone fractures in the leg*
• severe allergic reaction*†

* To learn more about this side effect, see the “Side effects of alendronate in detail” section below.
† An allergic reaction is possible with alendronate oral tablet. It wasn’t reported in the drug’s studies, but has happened since alendronate was approved for use.

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Common questions about side effects of alendronate

Here are answers to some common questions about side effects of alendronate oral tablet. If you have other questions, talk with your doctor or pharmacist.

How long does it take for side effects of alendronate to go away?

It depends. In most instances, mild side effects caused by alendronate go away on their own. This typically takes a few hours or days.

However, in rare cases, alendronate can cause serious side effects that may last long term. (See the next question below for examples.)

Talk with your doctor or pharmacist if you have side effects from alendronate that don’t go away. They can recommend the best way to treat your symptoms.

Does alendronate cause long-term side effects?

Yes, in some cases alendronate oral tablet may cause long-term side effects. These can occur if you take the drug for a long time or they may last for a while after you’ve stopped taking the drug.

Examples of long-term side effects reported with alendronate oral tablet include:

• death of tissue in the jaw bone*
• side effects in the esophagus*
• unusual bone fractures in the leg*

Talk with your doctor to learn more about these side effects and how to manage them. Ask your doctor for more information about how long these side effects of alendronate may last.

* To learn more about this side effect, see the “Side effects of alendronate in detail” section below.

Is weight gain a side effect of alendronate?

Weight gain is not a side effect that has been reported in studies of alendronate.

A recent study of zoledronate (a bisphosphonate drug like alendronate) showed the medication slows weight loss in women who have gone through menopause. And according to the authors of this study, there have been reports of weight gain with alendronate since the drug was approved for use.

But it’s important to note that this effect appears to be related to preventing weight loss that typically happens in women who have gone through menopause. Bisphosphonate drugs such as alendronate aren’t expected to cause significant weight gain.

Talk with your doctor if you’d like to learn more about whether medications you take could affect your weight.

Side effects of alendronate in detail

Below you’ll find details on some of the side effects of alendronate oral tablet.

Death of tissue in the jaw bone

Osteonecrosis of the jaw (death of tissue in the jaw bone) was rare in studies of people taking alendronate oral tablet. This side effect is serious.

Symptoms of osteonecrosis of the jaw include:

• mouth pain that may be severe
• trouble swallowing or pain when swallowing
• loose teeth
• trouble chewing
• exposed jaw bone

Certain factors can increase the risk of tissue death in the jaw bone with alendronate oral tablet. These include:

• having invasive dental work, such as tooth extraction
• having cancer
• taking certain other medications, including corticosteroids such as prednisone
• inadequate oral hygiene
• having certain other conditions, including an existing dental condition

Taking alendronate for a long time may also increase the risk of jaw osteonecrosis.

Ways to manage

If you need to have invasive dental work while taking alendronate, your doctor may temporarily stop your alendronate treatment. They’ll advise you about when it’s safe to resume treatment after your procedure.

Immediately contact your doctor if you have symptoms of jaw osteonecrosis. They’ll recommend the best treatment for you. This may involve jaw surgery and stopping your alendronate treatment.

Side effects in the esophagus

In studies, side effects in the esophagus were rare in people taking alendronate oral tablet. This side effect may be serious.

Esophageal side effects reported with alendronate include:

• esophagitis (inflammation of the esophagus). Symptoms include trouble swallowing and a sore throat
• ulcers and erosions
• rarely, stricture (narrowing) or perforation (holes)

Symptoms will vary with the specific side effect. But general symptoms to watch for include trouble swallowing, sore throat, and heartburn.

Certain factors can increase the risk of esophageal problems with alendronate oral tablet. These include:

• Lying down after you take alendronate: You should remain seated or standing upright for at least 30 minutes after taking a dose of alendronate. Also, you should not lie down until after you’ve eaten food.
• Not taking alendronate with enough water: You should take alendronate doses with at least 6–8 ounces of water.

Ways to manage

If you experience symptoms of esophageal problems, stop taking alendronate and tell your doctor right away. They’ll likely recommend making an appointment so they can examine your symptoms in person.

Unusual bone fractures in the leg

In studies, unusual bone fractures (breaks) in the leg were rare in people taking alendronate oral tablet. This side effect may be serious.

Unusual bone fractures in the leg caused by alendronate typically occur in the thigh. They can happen with minimal or even no physical trauma to the affected bone.

Symptoms can include a dull, aching thigh pain which begins weeks or months before a full fracture happens. Groin pain is another possible symptom. Other symptoms can include swelling, tenderness, and discomfort in your hip, groin, or thigh.

Ways to manage

If you experience symptoms of an unusual bone fracture, immediately tell your doctor. They’ll likely recommend making an appointment to examine your symptoms in person. They may temporarily or permanently stop your alendronate treatment.

Allergic reaction

For some people, alendronate oral tablet can cause an allergic reaction. This wasn’t reported in the drug’s studies, but has happened since alendronate was approved for use.

Symptoms can be mild or serious, and they may include:

• itchiness
• skin rash
• swelling under the skin, usually affecting eyelids, lips, hands, or feet
• swelling of the mouth, tongue, or throat, which can make it hard to breathe
• flushing (temporary warmth, redness, or deepening of skin color)

Ways to manage

For mild allergic reaction symptoms, such as a mild rash, call your doctor right away. They may recommend treatments to help manage your symptoms. They’ll also let you know whether you should keep taking the medication.

For severe allergic reaction symptoms, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms require immediate medical care because they can become life threatening. If you’ve had a serious allergic reaction to alendronate oral tablet, your doctor may recommend taking a different medication instead.

Warnings for alendronate

Below are some factors you may want to discuss with your doctor before taking alendronate oral tablet.

Warnings

It may not be safe for you to take alendronate oral tablet if you have specific health conditions. These are sometimes called drug-condition interactions. Other things may also affect whether alendronate oral tablet is a safe treatment option for you.

Before taking alendronate oral tablet, tell your doctor about your health and medications you take. Things to consider include:

• anemia
• dental problems
• difficulty swallowing
• digestive problems, such as ulcers
• esophageal problems, such as esophagitis
• kidney conditions, such as chronic kidney disease
• malabsorption syndrome (trouble absorbing certain nutrients)
• low blood calcium
• upcoming dental surgery
• past allergic reaction to alendronate

Alendronate and pregnancy

It’s not known whether alendronate oral tablet should be taken during pregnancy. If you’re planning a pregnancy or can become pregnant, talk with your doctor before taking this medication.

Alendronate and breastfeeding

It’s not known whether alendronate oral tablet should be taken while breastfeeding. If you’re currently breastfeeding or planning to do so, talk with your doctor before taking this medication.

Alendronate and alcohol

Alendronate oral tablet isn’t known to interact with alcohol.

However, alcohol can have negative effects on your bone health. Moderating or avoiding alcohol consumption may be beneficial in managing osteoporosis.

If you drink alcohol, talk with your doctor about whether it’s safe to consume it during your treatment with alendronate oral tablet.

What to ask your doctor

This article describes common and serious side effects of alendronate oral tablet. If your doctor prescribes this medication, they can discuss possible side effects with you. Let your doctor know if you have concerns or questions about treatment with this medication.

Here’s a list of some possible questions you may want to ask your doctor:

• Does alendronate have similar side effects as other bisphosphonate drugs?
• Do I have a higher risk of side effects than others?
• Does my risk of jaw osteonecrosis depend on the dosage of alendronate I take?

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.