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Alendronate belongs to a family of medications known as bisphosphonates. It is used to treat and prevent osteoporosis for postmenopausal women. It is also used to treat osteoporosis for men.
Alendronate may also be used to treat and prevent steroid-induced osteoporosis for men and women (osteoporosis caused by taking corticosteroids such as prednisone for long periods of time). It may also be used to treat Paget's disease of the bone for both men and women. It works by increasing the density of bones, making them less likely to break.
Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.
Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.
Tablets
10 mg Each white, oval, wax-polished tablet, with "MRK" engraved on one side and "936" on the other, contains alendronate monosodium salt trihydrate 13.05 mg, which is the molar equivalent to 10 mg of alendronate. Nonmedicinal ingredients: anhydrous lactose, carnauba wax, croscarmellose sodium, magnesium stearate, and microcrystalline cellulose. Gluten-free.
40 mg Each white, triangle-shaped, uncoated tablet, with "FOSAMAX" on one side and "MSD 212" on the other, contains alendronate monosodium salt trihydrate 52.21 mg, which is the molar equivalent to 40 mg of alendronate. Nonmedicinal ingredients: anhydrous lactose, croscarmellose sodium, magnesium stearate, and microcrystalline cellulose. Gluten-free.
70 mg Each white, oval, uncoated tablet, with an outline of a bone image on one side and "31" on the other, contains alendronate monosodium salt trihydrate 91.37 mg, which is the molar equivalent to 70 mg of alendronate. Nonmedicinal ingredients: anhydrous lactose, croscarmellose sodium, magnesium stearate, and microcrystalline cellulose. Gluten-free.
Solution
70 mg/75 mL Each bottle contains 91.35 mg of alendronate monosodium salt trihydrate equivalent to 70 mg alendronate. Nonmedicinal ingredients: artifical raspberry flavor, citric acid anhydrous, purified water, sodium citrate dehydrate, sodium saccharin, sodium propylparaben, and sodium butylparaben. Gluten-free.
Alendronate should not be taken by anyone who:
- is allergic to alendronate or to any of the ingredients of the medication
- is at increased risk of aspiration (accidently breathing liquid into the airways instead of swallowing it into the stomach) - this applies to taking the oral solution only
- cannot stand or sit upright for at least 30 minutes
- has an abnormality of the esophagus (passage leading from throat to stomach) that delays the emptying of the esophagus into the stomach
- has low blood calcium
- has reduced kidney function (creatinine clearance less than 35 mL/minute)
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
- abdominal pain
- bloating
- constipation
- diarrhea
- gas
- headache
- heartburn
- mild skin rash or redness
- nausea
- pain in bones, muscles, or joints
Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
- severe joint, bone, or muscle pain
- symptoms of low calcium levels such as muscle spasms, and prickling or tingling sensations around the mouth or in the hands or feet
- vision changes or eye pain
Stop taking the medication and seek immediate medical attention if any of the following occur:
- new or unusual pain in the hip or thigh
- signs of a serious allergic reaction (e.g., swelling of face or throat, hives, or difficulty breathing)
- signs of a severe skin reaction (e.g., high fever; rash; sores; painful blisters on the skin, mouth, or eyes; or skin peeling off)
- signs of damage to the esophagus (e.g., pain in the esophagus (throat area) or behind the breastbone, chest pain, difficulty swallowing, pain when swallowing, or new or worsening heartburn)
- symptoms of a stomach or intestinal ulcer (e.g., nausea, vomiting, abdominal pain, loss of weight or appetite, black or bloody stools, or vomiting blood)
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
The following medications may affect how alendronate works or increase the risk of side effects:
- antacids (wait at least ½ hour after taking alendronate to take antacids)
- ASA and ASA-containing products (when alendronate is taken in doses greater than 10 mg daily) - note that this does not apply to the 70 mg weekly dose
- calcium supplements (wait at least ½ hour after taking alendronate to take calcium supplements)
- other medications given by mouth (wait at least ½ hour after taking alendronate to take any other medication by mouth)
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. In many cases, interactions are intended or are managed by close monitoring. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Health Canada has issued new restrictions concerning the use of alendronate. To read the full Health Canada Advisory, visit Health Canada's web site at www.hc-sc.gc.ca.
Bone, joint, and muscle problems: Rarely, people taking this medication experience severe bone, joint, or muscle pain. This is usually reversed when the medication is stopped. In addition to this, there is a rare chance of femur (thigh bone) fractures, without any form of trauma. If you have new or unusual pain in the hip or thigh, contact your doctor as soon as possible.
Effects on the esophagus: Alendronate may irritate the lining of the esophagus (the passage from the throat to the stomach). Esophagitis, ulcers, and erosions have been reported for people who take alendronate. In some cases, these effects have been severe and have required hospitalization. Contact your doctor at once if you suddenly experience problems swallowing, find it painful to swallow, develop pain behind the sternum (breastbone), or have new or worsening heartburn.
To ease the passage of the medication to the stomach and thus reduce the potential for irritation of the esophagus, swallow alendronate with a full glass of plain water upon arising for the day. Do not lie down until 30 minutes have passed and you have eaten your first food of the day. Do not chew or suck on the tablet, as this may lead to ulcers in the mouth or throat. Do not take alendronate at bedtime or before getting up for the day.
Effects on the stomach and intestines: Rarely, people taking this medication have developed ulcers of the stomach or intestines. If you suffer from stomach problems, such as ulcers and severe indigestion, speak to your doctor to see if this medication is right for you. Get immediate medical attention if you have symptoms of a stomach or intestinal ulcer, such as nausea, vomiting, abdominal pain, loss of weight or appetite, black or bloody stools, or vomiting blood.
Jaw problems: Rarely, alendronate may cause jaw problems associated with delayed healing and infection, especially after tooth extractions. If you experience any pain in the jaw, especially after having a tooth removed, contact your doctor immediately.
Low calcium levels or vitamin D deficiency: Your doctor may test you for low calcium levels or vitamin D deficiency before you take alendronate.
Pregnancy: Alendronate has not been studied for use by pregnant women and therefore should not be taken during pregnancy. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding: Alendronate has not been studied for use by breast-feeding mothers and therefore should not be taken while breast-feeding.
Children and adolescents: The safety and effectiveness of using this medication have not been established for children under 18 years of age.
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