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Alendronate (Fosamax): 8 Answers Inc. Side Effects, Uses, and Cost

Answers to the most frequently asked questions about alendronate (Fosamax)

Alendronate or alendronic acid, sold under the brand name Fosamax, belongs to a class of drugs known as bisphosphonates. Alendronate is used to treat or prevent osteoporosis and Paget’s bone disease in patients who have been diagnosed or are deemed at risk.

The content on this page is provided for informational purposes only. If you have any questions or concerns about your treatment, you should talk to your doctor, pharmacist, or healthcare professional. This is particularly important if you are taking multiple medications or have any existing medical conditions.

  1. How does alendronate (Fosamax) work?
  2. How do you take alendronate (Fosamax)?
  3. What should you avoid while taking alendronate (Fosamax)?
  4. How long does alendronate (Fosamax) stay in your system?
  5. What are the side effects of alendronate (Fosamax)?
  6. Which alendronate (Fosamax) dosage is right for me?
  7. For how long is it safe to take alendronate (Fosamax)?
  8. How much does alendronate (Fosamax) cost?

1. How does alendronate (Fosamax) work?

Osteoporosis occurs when the body loses too much existing bone, doesn’t make enough new bone, or some combination of the two. This can lead to brittle bones that break easily. Alendronate works by slowing down the process at which the body removes old bone tissue. In turn, the cells working to form new bone can keep up with the rate that old bone is removed. Beyond preventing the loss of bone, alendronate can help to restore healthy bone density and make bones less prone to fractures.

2. How do you take alendronate (Fosamax)?

Alendronate, or Fosamax, is a once-weekly oral tablet. To ensure your body can properly absorb the medication there are several important steps to follow. First, you must take Fosamax as soon as you get up for the day, not before bed. You should swallow the tablet with a glass of plain water. Do not drink or eat any other liquids or foods for at least 30 minutes after taking the medication. You will need to stay upright — sitting or standing — during this 30 minute period. Do not lie down directly after taking alendronate. If you lie down before 30 minutes have passed, alendronate can irritate your esophagus. During the thirty minutes that you remain upright, you must also avoid eating or drinking anything aside from plain water. Not following the above steps properly will reduce the effectiveness of the medication and may increase your risk of side effects.

It is also worth noting that you should avoid chewing or sucking on the tablet. Not only will this reduce the medication’s effectiveness, but it may also lead to mouth ulcers.

3. What should you avoid while taking alendronate (Fosamax)?

Patients should avoid smoking tobacco or drinking large quantities of alcohol if possible, as both activities can worsen osteoporosis. You should also speak with your doctor about any other medications or supplements you're taking to ensure they will not reduce the effectiveness of alendronate.

4. How long does alendronate (Fosamax) stay in your system?

Due to the nature of osteoporosis, alendronate is a long-term treatment for a long-term condition. Alendronate works itself into your bone tissue, where its activity helps strengthen your bone. For that reason, alendronate stays in your system for an extended period of time. But once alendronate gets incorporated into your bone tissue, it isn’t active anymore. This is why you’ll likely need to take alendronate once a week, likely for at least 3 years. . If you’re concerned about the long-term nature of the drug, you should speak with your doctor about any risks and/or benefits associated with treatment.

5. What are the side effects of alendronate (Fosamax)?

Alendronate can potentially cause side effects ranging from mild to severe. The list below includes some of the most common side effects but is not a complete list. Mild side effects may go away after a few days or weeks of consistent medication-taking, but if they persist or worsen you should speak with your doctor.

Common Side Effects:

Severe Side Effects:

  • Loose teeth, numb jaw, or jaw pain (these may be signs of osteonecrosis in the jawbone)
  • Hip or groin pain
  • Pain or difficulty when swallowing
  • Muscle spasms
  • Severe joint pain
  • Stomach ulcers
  • Ulcers and irritation in the esophagus

If you experience any of these serious side effects, you should speak with your doctor or seek immediate medical attention if it is an emergency.

In some rare cases, patients can experience allergic reactions. Seek emergency medical care if you experience any of the following symptoms after taking Copaxone.

  • Skin rash
  • Wheezing
  • Tightness in the throat or chest
  • Difficulty talking or breathing
  • Swelling of the face, lips, tongue, or throat

6. Which alendronate (Fosamax) dosage is right for me?

The proper dosage of alendronate will vary between patients and is based on several factors. You should always follow your doctor’s instructions or the directions on the label. The information below refers to typical doses of alendronate.

  • For the treatment of osteoporosis – 10 mg daily or 70 mg weekly
  • For the treatment of Paget’s disease – 40 mg daily for 6 months
  • For prevention of osteoporosis – 5 mg daily or 35 mg weekly

7. For how long is it safe to take alendronate (Fosamax)?

When determining how long to take alendronate you should speak with your doctor about your situation. The following information is based on general guidelines but may not apply to every situation.

Typically, it is advised that patients take oral bisphosphonates such as alendronate for a maximum of ten years if they are considered high risk. However, patients should have their risk for fractures assessed every two to three years, and your doctor may recommend taking a temporary break from alendronate treatment after 5 years.

8. How much does alendronate (Fosamax) cost?

The cost of Alendronate will vary greatly based on the insurance coverage and location of individual patients. The cost for Fosamax oral tablets is around $143 for a four-tablet pack. For a standard dose, that will last one month. It is also worth noting that a generic version of alendronate may be available as well and will cost less than Fosamax.


The content on this page is provided for informational purposes only. If you have any questions or concerns about your treatment, you should talk to your doctor, pharmacist, or healthcare professional. This is particularly important if you are taking multiple medications or have any existing medical conditions.

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