Fosamax is the brand name for alendronate, a common osteoporosis drug. It may not suit everybody, so you may explore options like alternative medications, therapies, and lifestyle strategies.
Medically reviewed by Alexandra Perez, PharmD, MBA, BCGP
Fosamax is a prescription medication that helps prevent and treat osteoporosis. It’s a brand-name medication containing the active ingredient alendronate. Alendronate is an effective drug for osteoporosis and other bone conditions.
Fosamax can have adverse effects, such as diarrhea, chest pain, and risk of fractures, and to avoid these, you may consider alternatives.
Alternatives to Fosamax include other medications and treatment options, and we’ll look at some of these here.
Osteoporosis medications
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Osteoporosis affects about 10 million people over 50 in the United States. Most of them are female, but 2 million are male.
Osteoporosis causes loss of bone density. Your doctor may prescribe medications to help manage the condition.
The first-line treatment for osteoporosis typically includes bisphosphonates, like:
Bisphosphonates help maintain bone density by slowing the speed at which your bones deteriorate. They can come as oral weekly or monthly tablets, an injection, or in liquid form. It can take 6–12 months for bisphosphonates to work.
Your doctor may also suggest you take vitamin D and calcium supplements.
However, healthcare professionals will not recommend or prescribe bisphosphonates if you:
are hypersensitive to bisphosphonates
have hypocalcemia or low calcium levels
have chronic kidney disease
have esophageal disorders
Your healthcare team may consider other medications and treatment options in these cases.
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Besides bisphosphonates, other osteoporosis medications include hormone-like medications and biological medicines or antibodies.
Hormone-like medications
These medications have effects similar to hormones and include:
Calcitonin salmon (Miacalcin): This drug helps control calcium levels in your blood, and you can take it by injection or nasal spray.
Raloxifene (Evista): This medication is a selective estrogen receptor modulator (SERM). SERMs work by maintaining bone density and reducing the risk of fractures, similar to estrogen. This is a SERM that’s taken as a tablet once per day.
Parathyroid hormones (PTHs): There are two types of PTHs, teriparatide (Forteo) and abaloparatide (Tymlos), both injectable. The drugs control the body’s calcium and phosphate levels and help stimulate cells to produce new bone.
Biological medications or antibodies
Biological medications may best suit people with osteoporosis who can’t take bisphosphonates. They contain proteins and other substances the body produces. They include:
Denosumab (Prolia): This drug reduces bone breakdown and helps maintain bone density. It is an injectable medication that you will usually take every 6 months.
Romosozumab (Evenity): This drug helps strengthen your bones. You can take this medication as an injection once each month for 12 months.
What are the side effects of osteoporosis medication?
You may sometimes experience side effects with osteoporosis medications, some similar to menopause and osteoporosis symptoms.
Two separate 105-mg subcutaneous injections, totaling 210 mg, monthly for 12 months.
Is there a dosage difference for males and females?
The dosage for men and women to treat osteoporosis and bone loss can be the same. However, dosages can also vary depending on the condition. For example, calcitonin can also treat conditions like Paget’s disease, which may mean a different dosage.
Alternative treatments for osteoporosis
Apart from medication, your doctor may consider other treatments or suggest lifestyle strategies to help you manage osteoporosis. These include:
Fosamax, the brand-name version of alendronate, is a prescription medication a doctor may prescribe to help you treat and manage osteoporosis. The active ingredient, alendronate, belongs to a class of drugs known as bisphosphonates and is usually the first-line treatment for people with osteoporosis.
Fosamax and other bisphosphonates may not suit everyone. If you can’t take Fosamax or other bisphosphonates to treat osteoporosis, hormone-like medications, and antibodies are available. Besides medications, you may also consider hormone replacement therapy (HRT), physical therapy, and lifestyle strategies.
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