By Medically reviewed by hellodoktor

Generic Name: Fosamax Brand Name(s): Generics only. No brands available.


What is Fosamax® (alendronate) used for?

Fosamax® is commonly used for treating and preventing osteoporosis in certain patients. It may also be used for other conditions as determined by your doctor.

Alendronate is a bisphosphonate. It works by slowing bone loss.

How should I take Fosamax® (alendronate)?

Use Fosamax® as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Swallow Fosamax® whole. Do not break, crush, chew, or suck on the tablet before swallowing.

Take Fosamax® by mouth on an empty stomach in the morning at least 30 minutes before your first food, drink, or other medicine of the day. Do not take Fosamax® at bedtime or before you get out of bed in the morning.

Take Fosamax® with a full glass of plain water (8 oz/240 mL). Do not take alendronate with mineral water, coffee, tea, or juice. Do not lie down for 30 minutes after taking Fosamax® and until you eat your first food of the day.

Be sure you understand how to take Fosamax®. Contact your doctor or pharmacist if you have any questions.

Continue to use Fosamax® even if you feel well. Do not miss any doses.

How do I store Fosamax® (alendronate)?

Fosamax® is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Fosamax® in the bathroom or the freezer. There may be different brands of Fosamax® that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Fosamax® down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Fosamax® (alendronate)?

Before using this drug, tell your doctor if:

  • You are pregnant or breastfeeding. This is because, while you are expecting or feeding a baby, you should only take medicines on the recommendation of a doctor.
  • You are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
  • You have allergy with any of active or inactive ingredients of Fosamax® or other medications.
  • You have any other illnesses, disorders, or medical conditions.
  • You have a history of stomach or bowel problems (e.g., inflammation, ulcer), esophagus problems (e.g., heartburn, reflux disease, severe irritation), or kidney problems, or if you have difficult or painful swallowing.
  • You have low blood vitamin D levels, cancer, anemia, asthma, blood clotting problems, an infection, calcium metabolism problems, or nutrient absorption problems (e.g., malabsorption syndrome), or you are unable to take calcium or vitamin D supplements.
  • You have poor dental hygiene or other dental problems, or you will be having a dental procedure (e.g., tooth extraction).
  • You smoke or drink alcohol.
  • You have had or will be having chemotherapy or radiation treatment.
  • You have a mental disorder or other condition that may decrease your ability to follow the dosing instructions for Fosamax®.
  • You are taking any medicines that can cause jaw bone problems. There are many medicines that can do this. Ask your doctor or pharmacist if you are not sure.

Tell your doctor or dentist that you take Fosamax® before you receive any medical or dental care, emergency care, or surgery.

Fosamax® may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use alendronate with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.

Talk with your doctor before you drink alcohol, smoke, or use other tobacco products while taking alendronate.

Follow the diet and exercise program given to you by your health care provider. Talk to your doctor about whether you should take a calcium and vitamin D supplement while you use alendronate.

Talk to your doctor about the use of weight-bearing exercises to help prevent weak bones.

Certain fractures of the thigh bone (femur) have been reported in patients using bisphosphonates. It is unknown if bisphosphonates contributed to the fractures. Contact your doctor right away if you experience hip, thigh, or groin pain. Discuss any questions or concerns with your doctor.

Fosamax® may cause jawbone problems in some patients. Your risk may be greater the longer you take Fosamax® or if you have cancer, poor dental hygiene, ill-fitting dentures, or certain other conditions (e.g., anemia, blood clotting problems, dental problems, infection). Your risk may also be greater if you have certain dental procedures or you use certain medicines or therapies (e.g., chemotherapy, corticosteroids, radiation). Talk to your doctor about having a dental exam before you start to use Fosamax®. Ask your doctor any questions you may have about dental treatment while you use alendronate.

Proper dental care is important while you are taking alendronate. Brush and floss your teeth and visit the dentist regularly.

Fosamax® may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to Fosamax®. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.

Certain dental procedures should be avoided if possible while you are using alendronate. Tell your doctor or dentist that you take Fosamax® before you receive any medical or dental care, emergency care, or surgery.

Worsening of asthma has been reported in patients taking medicines like this one. Discuss any questions or concerns with your doctor.

Lab tests, including bone density and blood calcium levels, may be performed while you use Fosamax®. These tests may be used to monitor your condition or check for side effects. Your doctor may also want to evaluate you periodically while you take alendronate to assess the need to continue treatment. Be sure to keep all doctor and lab appointments.

Fosamax® should not be used in children; safety and effectiveness in children have not been confirmed.

Is it safe during pregnancy or breastfeeding?

There are no adequate studies in women for determining risk when using Fosamax® during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Fosamax®. Fosamax® is pregnancy risk category C, according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk
  • B=No risk in some studies
  • C=There may be some risk
  • D=Positive evidence of risk
  • X=Contraindicated
  • N=Unknown

Side effects

What side effects can occur from Fosamax® (alendronate)?

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most common side effects persist or become bothersome:

  • Constipation
  • Diarrhea
  • Dizziness
  • Feeling bloated or full
  • Flu-like symptoms at the start of treatment
  • Gas
  • Headache
  • Mild back, muscle, or joint pain
  • Mild stomach pain or upset
  • Nausea
  • Taste changes
  • Vomiting

Seek medical attention right away if any of these severe side effects occur:

  • Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, throat, or tongue)
  • Black, tarry, or bloody stools
  • Chest pain
  • Coughing or vomiting blood
  • Difficult or painful swallowing
  • Mouth sores
  • New, worsening, or persistent heartburn
  • Red, swollen, blistered, or peeling skin
  • Severe bone, muscle, or joint pain (especially in the hip, groin, or thigh)
  • Severe or persistent sore throat or stomach pain
  • Swelling of the hands, legs, or joints; swelling or pain in the jaw
  • Symptoms of low blood calcium (e.g., spasms, twitches, or cramps in your muscles; numbness or tingling in your fingers, toes, or around your mouth)

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.


What drugs may interact with Fosamax® (alendronate)?

Fosamax® may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Products that may interact with this drug are:

  • Aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) (e.g., ibuprofen) because the risk of side effects, such as esophagus or stomach irritation, may be increased.
  • Corticosteroids (e.g., prednisone) or angiogenesis inhibitors (e.g., bevacizumab) because the risk of jawbone problems may be increased.

Does food or alcohol interact with Fosamax® (alendronate)?

Fosamax® may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Fosamax® (alendronate)?

Fosamax® may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.


The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using Fosamax® (alendronate).

What is the dose of Fosamax® (alendronate) for an adult?

Usual Adult Dose for Osteoporosis

Treatment of Osteoporosis in Postmenopausal Women; To Increase Bone Mass in Men with Osteoporosis:

  • 10 mg orally once a day
  • 70 mg orally once a week

Treatment of Glucocorticoid-Induced Osteoporosis:

  • 5 mg orally once a day
  • 10 mg orally once a day in postmenopausal women not receiving estrogen

Usual Adult Dose for Prevention of Osteoporosis

5 mg orally once a day

35 mg orally once a week

Usual Adult Dose for Paget’s Disease

40 mg orally once a day for six months

What is the dose of Fosamax® (alendronate) for a child?

The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is Fosamax® (alendronate) available?

Fosamax® is available in the following dosage forms and strengths:

  • Tablet

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Fosamax®, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: August 8, 2017 | Last Modified: September 13, 2019

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