Fosamax, Alendronate, Binosto

Introduction

Written by Lee Holland, PharmD, MPH
Medically reviewed by Brittany A. Duke, PharmD, RPh
Updated on August 9, 2023

Alendronate (a LEN droe nate) is a generic medication prescribed for osteoporosis and Paget’s disease. Alendronate belongs to a group of drugs called bisphosphonates.

Side effects of alendronate

Alendronate may cause mild or serious side effects. More common mild side effects of alendronate and its serious side effects are listed below. This article doesn’t include all possible side effects of the drug. Side effects can vary based on your age, overall health, and any other medications you take.

To learn more about alendronate’s side effects, ask your doctor or pharmacist. You can also refer to the prescribing information for alendronate listed in the “Resources” section.

Mild side effects

More common mild side effects reported with some forms of alendronate are listed below.

This article doesn’t include all possible mild side effects of the drug. To learn more about alendronate’s side effects based on the form, refer to the prescribing information for alendronate listed in the “Resources” section.

With many drugs, mild side effects may go away within a few days or a couple of weeks. If the side effects are bothersome, tell your doctor or pharmacist. They may be able to suggest ways to manage them.

The mild side effects of alendronate’s oral tablet and solution include:

• abdominal pain
• bone, muscle, or joint pain
• nausea
• indigestion
• mild allergic reaction*

* For details about this side effect, see the “Interactions and warnings for alendronate” section.

Serious side effects

Serious side effects of alendronate are listed below.

This article doesn’t include all possible serious side effects of the drug. To learn more about alendronate’s side effects based on the form, refer to the prescribing information for alendronate listed in the “Resources” section.

With many drugs, serious side effects are possible but not common. If you have serious side effects from this drug, call your doctor right away. If you’re having severe symptoms or a medical emergency, call 911 or a local emergency number.

In general, alendronate’s serious side effects include:

• severe bone, muscle, or joint pain
• death of tissue in the jaw bone
• severe allergic reaction*

* For details about this side effect, see the “Interactions and warnings for alendronate” section.

Common questions about alendronate

Below you’ll find answers to a few commonly asked questions about alendronate.

What is alendronate’s mechanism of action? How does the drug work?

Alendronate works by stopping your body from breaking down bone tissue. The body is constantly breaking down and building up bone. It does this so that calcium and other minerals stored in the bones can be used.

Alendronate works by stopping breakdown of bone tissue. This helps make bones stronger.

Alendronate starts working after 1 month of treatment. But it may take 6–12 months for the drug to fully protect your bones.

If you’d like to know more about this, talk with your doctor or pharmacist.

Can alendronate cause long-term side effects?

No, long-term side effects aren’t expected with alendronate. In studies,* specific side effects weren’t seen in people who had taken the drug for a long time. Long lasting side effects after treatment ended also weren’t reported.

Talk with your doctor if you have questions about possible long-term side effects with alendronate.

* For details about alendronate’s studies, see its prescribing information in the “Resources” section below.

Do you have to take alendronate on an empty stomach?

Yes, you should take alendronate on an empty stomach. And you should swallow the medication with a glass of plain water.

Wait at least 30 minutes after taking alendronate before eating or taking other medications. It’s also important to stand or sit up for at least 30 minutes after taking alendronate. And you should eat something before laying down.

If you have other questions about how to take this drug, talk with your doctor or pharmacist.

Uses of alendronate

The Food and Drug Administration (FDA) approves prescription drugs such as alendronate for certain conditions. Approved uses for alendronate are described below.

Use for osteoporosis

Doctors may prescribe alendronate oral tablet or solution to treat or help prevent osteoporosis. It’s used for this purpose in certain adults. It’s usually prescribed as a long-term treatment.

Specifically, doctors may prescribe the drug for this purpose to:

• treat or prevent osteoporosis in females* who’ve gone through menopause
• treat osteoporosis in males*
• treat osteoporosis that’s caused by steroid medications

With osteoporosis, bone tissue is broken down faster than it’s made. This causes bones to become brittle and fragile. And they can become weak and break easily.

Alendronate is sometimes prescribed together with calcium and vitamin D supplements for osteoporosis.

Doctors may prescribe alendronate oral tablet and  solution for only 3–5 years in certain people. This includes people at low risk of a bone fracture. It’s not known for sure how long treatment with alendronate should be continued

* Sex and gender exist on spectrums. In this article, we use the terms “male” and “female” to refer to a person’s sex assigned at birth.

Use for Paget’s disease

Doctors may prescribe alendronate oral tablet or solution for treating Paget’s disease. It’s used for this purpose in adults. It’s usually prescribed as a long-term treatment.

With Paget’s disease, bone tissue is broken down and made too quickly. This causes the bones to have structural changes, become weak, and to break easily.

Alendronate is sometimes prescribed together with calcium and vitamin D supplements for Paget’s disease.

Doctors may prescribe alendronate oral tablet and  solution for only 3–5 years in certain people. This includes people at low risk of a bone fracture. It’s not known for sure how long treatment with alendronate should be continued

Interactions and warnings for alendronate

Below, you’ll find information about alendronate’s possible interactions and warnings.

Interactions of alendronate

Certain things may affect how a drug works. These include getting vaccines, consuming alcohol or certain foods, or taking the drug with other medications. This effect is called a drug interaction.

Before you take alendronate, ask your doctor to check for possible interactions. Be sure to tell them about any of the following you take or use:

• prescription or over-the-counter drugs
• vitamins, herbs, or supplements

To learn about drug-condition interactions, see the “Warnings for alendronate” section below.

Warnings for alendronate

Alendronate should not be taken by certain people.

Alendronate could cause harm to people with certain health conditions. This effect is called a drug-condition interaction. Other factors can also affect whether alendronate is a safe option for you. These warnings may differ based on the form of alendronate you take.

Ask your doctor about specific warnings for alendronate, and be sure to tell your doctor about your:

• current health, including any allergies to medications
• past health conditions or surgeries

Allergic reaction

Alendronate can cause an allergic reaction in some people. Severe allergic reactions are rare but possible.

If you’ve had an allergic reaction to alendronate or any of its ingredients, your doctor will likely not prescribe alendronate. They can tell you about medications that are safer options for you.

A mild allergic reaction may cause the following symptoms:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A severe allergic reaction may cause the following symptoms:

• swelling under your skin, usually in your hands, feet, eyelids, or lips
• swelling of your mouth, throat, or tongue, which can cause breathing problems

If you have an allergic reaction to alendronate, call your doctor right away. If you have severe symptoms, call 911 or a local emergency number.

Overdose of alendronate

You should not take more alendronate than your doctor prescribes. For some drugs, doing so may lead to harmful effects or overdose.

If you think you’ve taken too much alendronate, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have concerning symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.

Pregnancy or breastfeeding and alendronate

Information about alendronate and pregnancy and breastfeeding is described below.

Alendronate and pregnancy

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

Your doctor can discuss treatment options for your condition during pregnancy. Together, you can discuss the risks and benefits of your treatment options and decide whether or not you should take alendronate during pregnancy.

Alendronate and breastfeeding

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

If you’re planning to breastfeed, talk with your doctor about treatment options for your condition. Together, you can discuss the risks and benefits of your treatment options and decide whether or not you should take alendronate during this time. Your doctor may recommend other healthy ways to feed your child.

What to ask your doctor

Let your doctor know if you have questions about alendronate or would like more details about it.

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

• What over-the-counter medications should I avoid while  taking alendronate?
• How can I help prevent stomach upset with alendronate?
• What kind of vitamin or mineral supplements should I take with alendronate?

Resources

• Alendronate sodium — alendronate sodium solution. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/81589178-10c9-4806-91eb-54e638d35b8d/spl-doc
• Alendronate sodium — alendronate sodium tablet. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/83e3ba94-d882-4b5c-87cb-af1eb0997efc/spl-doc
• Food and Drug Administration. (2023). Orange Book: Approved drug products with therapeutic equivalence evaluations. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm

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.