Fosamax : Uses, Side Effects, Interactions & More

Why is this medication prescribed?

Fosamax (Alendronate) is used to treat and prevent osteoporosis (a condition in which bones become thin and weak and break easily) in women who have gone through menopause (“life change”, end of menstrual periods). and to treat osteoporosis in men. Fosamax is also used to treat osteoporosis in men and women taking corticosteroids (a type of medicine that can cause osteoporosis in some patients). Fosamax is also used to treat Paget’s disease of bone (a condition in which the bones are soft and weak and can easily become deformed, painful, or broken). Fosamax is in a class of medications called bisphosphonates. It works by preventing bone breakdown and increasing the density (thickness) of the bones.

How should this medicine be used?

Fosamax (Alendronate) comes as a tablet, an effervescent tablet, and a solution (liquid) to take by mouth. The solution is usually taken on an empty stomach once a week in the morning. The 5 mg and 10 mg tablets are generally taken on an empty stomach once a day in the morning, and the 35 mg and 70 mg tablets are generally taken on an empty stomach once a week in the morning. The 40 mg tablets are usually taken once a day in the morning for six months to treat Paget’s disease of bone. Effervescent tablets are usually taken on an empty stomach once a week in the morning. Follow the directions on your prescription label carefully and ask your doctor or pharmacist to explain any parts you do not understand. Take Fosamax exactly as directed. Do not take more or less or take it more often than prescribed by your doctor.

Fosamax may not work properly and may damage the esophagus (tube between the mouth and stomach) or cause sores in the mouth if it is not taken according to the following instructions. Tell your doctor if you do not understand, you do not think you will remember, or you are unable to follow these instructions:

  • You should take Fosamax right after you get out of bed in the morning, before you eat or drink anything. Never take Fosamax before bedtime or before waking up and getting out of bed for the day.
  • After taking Fosamax, do not eat, drink, or take any other medications (including vitamins or antacids) for at least 30 minutes. Do not lie down for at least 30 minutes after taking Fosamax. Sit upright or stand upright until at least 30 minutes have passed and you have eaten your first meal of the day.
  • If you are taking Fosamax tablets, swallow the tablet with a full glass (6 to 8 ounces [180 to 240 ml] ) of plain water. Never take Fosamax tablets with tea, coffee, juice, milk, mineral water, sparkling water, or any other liquid other than plain water. Swallow the tablets whole; do not split, chew, or crush them. Do not suck the tablets.
  • If you are taking Fosamax oral solution, drink at least 2 ounces (1/4 cup [60 milliliters] ) of water after taking Fosamax oral solution. Never take Fosamax solution with tea, coffee, juice, milk, mineral water, sparkling water, or any other liquid other than plain water.
  • If you are taking Fosamax effervescent tablets, dissolve one effervescent tablet in a full glass (4 ounces [120 milliliters] ) of still drinking water before drinking. Never dissolve Fosamax effervescent tablets in tea, coffee, juice, milk, mineral water, sparkling water, or any other liquid other than plain water. Wait at least 5 minutes after the fizzing stops, stir the solution for 10 seconds and drink it. Do not swallow, suck, or chew the effervescent tablets.

Fosamax controls osteoporosis and Paget’s disease of bone, but it does not cure these conditions. It may take 3 months or more before your bone density begins to increase. Fosamax helps treat and prevent osteoporosis only if it is taken regularly. Keep taking Fosamax even if you feel fine. Do not stop taking Fosamax without talking to your doctor, but do talk to your doctor from time to time about whether you still need to take Fosamax.

Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.

Other uses for this medicine

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?

Before taking Fosamax,

  • Tell your doctor and pharmacist if you are allergic to Fosamax or any other medications.
  • Tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: angiogenesis inhibitors such as bevacizumab (Avastin), everolimus (Afinitor, Zortress), pazopanib (Votrient), sorafenib (Nexavar), or sunitinib (Sutent); aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Ibu-Tab, Motrin, others) and naproxen (Aleve, Naprelan, Naprosyn, others); cancer chemotherapy; or oral steroids such as dexamethasone, methylprednisolone (Medrol), and prednisone (Rayos). Your doctor may need to change the doses of your medications or monitor you closely for side effects.
  • If you are taking other medications, including supplements, vitamins, or antacids by mouth, take them at least 30 minutes after taking Fosamax.
  • Tell your doctor if you are unable to sit or stand upright for at least 30 minutes, if you have or have ever had a low level of calcium in your blood, a risk of inhaling food or liquid into your lungs, or if you have any problems with your esophagus. Your doctor may tell you not to take Fosamax.
  • Tell your doctor if you are having radiation therapy or if you are on a sodium restricted diet (if you are taking effervescent tablets); and if you have or have ever had anemia (a condition in which red blood cells do not carry enough oxygen to all parts of the body); a low level of vitamin D in your body; difficulty swallowing heartburn; ulcers or other stomach problems; Cancer; any type of infection, especially in the mouth; problems with your mouth, teeth, or gums any condition that prevents blood from clotting normally; or dental or kidney disease.
  • Tell your doctor if you are pregnant or breastfeeding. Also tell your doctor if you plan to become pregnant at any time in the future, because Fosamax can remain in your body for years after you stop taking it. Call your doctor if you become pregnant during or after your treatment.
  • You should know that Fosamax can cause osteonecrosis of the jaw (ONJ, a serious condition of the jaw bone), especially if you have surgery or dental treatment while taking the drug. A dentist should examine your teeth and perform any necessary treatments, including cleaning or repairing ill-fitting dentures, before you start taking Fosamax. Make sure you brush your teeth and clean your mouth properly while taking Fosamax. Talk to your doctor before undergoing any dental treatment while taking this medicine.
  • You should know that Fosamax can cause severe bone, muscle, or joint pain. You may start to feel this pain within a few days, months, or years after you first take Fosamax. Although this type of pain can start after you’ve taken Fosamax for some time, it is important that you and your doctor know that it can be caused by Fosamax. Call your doctor immediately if you experience severe pain at any time during your treatment with Fosamax. Your doctor may tell you to stop taking Fosamax, and your pain may go away after you stop taking the medicine.
  • Talk to your doctor about other things you can do to prevent osteoporosis from developing or getting worse. Your doctor will likely tell you to avoid smoking and drinking large amounts of alcohol and to follow a regular program of exercise with weights.

What special dietary instructions should I follow?

You should eat and drink plenty of foods and drinks rich in calcium and vitamin D while you are taking Fosamax. Your doctor will tell you which foods and drinks are good sources of these nutrients and how many servings you need each day. If you find it difficult to eat enough of these foods, tell your doctor. In that case, your doctor may prescribe or recommend a supplement.

What should I do if I forget a dose?

If you miss a dose of Fosamax once a day, do not take it later in the day. Skip the missed dose and take a dose the next morning as usual. Do not take a double dose to make up for the one you forgot.

If you miss a dose of Fosamax once a week, take the dose the morning after you remember. Then go back to taking a dose once a week on your regular day. Never take a double dose to make up for a missed one and never take more than one dose in a day.

What side effects can this medication cause?

Fosamax may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • nausea
  • stomach pain
  • constipation
  • diarrhea
  • gas
  • bloating or fullness in the stomach
  • change in ability to taste food
  • headache
  • dizziness
  • swelling of the joints, hands, or legs
  • muscle spasms, twitches, or cramps

Some side effects can be serious. If you experience any of the following symptoms or those listed in the SPECIAL PRECAUTIONS section, call your doctor immediately before you take any more Fosamax:

  • new or worsening heartburn
  • difficulty swallowing
  • pain on swallowing
  • chest pain
  • bloody vomit or vomit that looks like coffee grounds
  • black, tarry, or bloody stools
  • fever
  • blisters or peeling skin
  • rash (may be made worse by sunlight)
  • itching
  • hives
  • swelling of eyes, face, lips, tongue, or throat
  • difficulty breathing
  • hoarseness
  • painful or swollen gums
  • loosening of the teeth
  • numbness or heavy feeling in the jaw
  • poor healing of the jaw
  • eye pain
  • dull, aching pain in the hips, groin, or thighs

Taking a bisphosphonate medicine such as Fosamax for osteoporosis can increase the risk of breaking the thigh bone. You may feel pain in your hips, groin, or thighs for several weeks or months before your bones break, and you may find that one or both of your thigh bones have fractured even though you have not fallen or experienced another. trauma. It is unusual for the thigh bone to break in healthy people, but people with osteoporosis can break this bone even if they do not take Fosamax. Talk to your doctor about the risks of taking Fosamax.

Fosamax may cause other side effects. Call your doctor if you have any unusual problems while taking this medicine.

If you experience a serious side effect, you or your doctor can submit a report online to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program ( or by phone (1-800-332-1088).

What should I know about storage and disposal of this medication?

Keep this medicine in the container it came in, tightly closed, and out of the reach of children. Store at room temperature and away from excess heat and moisture (not in the bathroom). Do not freeze the Fosamax solution.

It is important to keep all medicines out of the sight and reach of children, as many containers (such as those containing weekly pills and those for eye drops, creams, patches, and inhalers) are not child-resistant and small children can easily open them. To protect young children from poisoning, always close the safety caps and immediately place the medicine in a safe place, one that is upright and out of their sight and reach.

Unnecessary medications must be disposed of in special ways to ensure that pets, children, and others cannot consume them. However, you should not flush this medicine down the toilet. Instead, the best way to dispose of your medications is through a drug take-back program. Talk to your pharmacist or contact your local garbage / recycling department to find out about take-back programs in your community. See the FDA Safe Drug Disposal website ( for more information if you do not have access to a take-back program.

In case of emergency/overdose

In the event of an overdose, give the victim a full glass of milk and call your local poison control center at 1-800-222-1222. If victim has passed out or is not breathing, call local emergency services at 911. Do not allow victim to lie down and do not try to make victim vomit.

Symptoms of overdose may include the following:

  • heartburn
  • nausea
  • stomach pain
  • bloody vomit or vomit that looks like coffee grounds
  • difficulty swallowing or pain when swallowing
  • bloody or black and tarry stools

What other information should I know?

Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your body’s response to Fosamax.

Do not let anyone else take your medicine. Ask your pharmacist any questions you have about refilling your prescription.

It is important that you keep a written list of all prescription and over-the-counter (over-the-counter) medications you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should take this list with you each time you visit a doctor or if you go into hospital. It is also important information to take with you in case of emergencies.

Brand names

  • Binosto®
  • Fosamax®

Disclaimer: We have made every effort to ensure that all information is factually accurate, comprehensive and up-to-date. However, this article should not be used as a licensed health care professional’s choice of knowledge and expertise. You should always consult your doctor or other health care professional before taking any medication. The information given here is subject to change and it has not been used to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions or adverse effects. The lack of warning or other information for any drug does not indicate that the combination of medicine or medication is safe, effective or appropriate for all patients or all specific uses.

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