Alendronate (Fosamax) — A Practical Guide for Patients

Alendronate is a bisphosphonate medicine used to treat and prevent osteoporosis. It slows bone loss and lowers the chance of spine and hip fractures. Many people know it by the brand name Fosamax, but generic alendronate works the same way.

How and when to take alendronate

Take alendronate first thing in the morning on an empty stomach. Swallow the tablet whole with a full glass (240 ml) of plain water. Don’t chew or suck the tablet. Stay sitting or standing for at least 30 minutes after taking it and don’t lie down. Wait at least 30–60 minutes before eating, drinking anything else, or taking other medicines, especially calcium, iron, magnesium, or antacids — they block absorption.

Typical dosing is either 10 mg once daily or 70 mg once weekly, depending on what your doctor prescribes. If you take the weekly dose and forget it, take it the morning after you remember. Don’t take two doses on the same day.

Side effects, risks, and what to watch for

Common side effects are heartburn, stomach pain, gas, constipation, or diarrhea. These often improve after the first weeks. Serious but rare problems include severe esophagitis (inflammation or ulcers of the esophagus), atypical thigh bone fractures, and osteonecrosis of the jaw — a condition where jaw bone heals poorly after dental procedures.

Tell your doctor if you have difficulty swallowing, new or worsening heartburn, severe thigh or groin pain, or jaw pain. If you need a tooth extraction or major dental work, mention you're on alendronate so your dentist and doctor can plan care.

Alendronate is not for people who can’t sit upright for 30 minutes, have active esophageal problems (like strictures or severe reflux), or have very low kidney function. Women who are pregnant or breastfeeding should avoid it.

Your doctor may check kidney function before starting treatment and repeat it if you have kidney disease. Bone density (DEXA) scans are used to track how well the drug is working over time.

If oral alendronate causes persistent stomach problems or you have trouble following the dosing rules, ask about alternatives. Doctors can use different bisphosphonates or give an intravenous option like zoledronic acid in clinic.

Thinking about buying alendronate online? Only use licensed pharmacies that require a prescription and show clear contact details. Counterfeit medicines are a real risk — if a deal looks too good, steer clear.

Storage is simple: room temperature, dry place away from direct sunlight. If you miss a dose, follow your doctor’s instructions or the leaflet — usually take the missed dose the next morning but don’t double up on the same day.

Have questions about interactions or long-term use? Ask your prescriber. Small lifestyle steps — enough calcium and vitamin D, regular weight-bearing exercise, and quitting smoking — make the medicine more effective at protecting your bones.