Alendronate

💊 What is Alendronate used for?

• •Treating osteoporosis in women after menopause, which helps reduce the chance of hip or spinal fractures
• •Preventing osteoporosis in women after menopause
• •Increasing bone mass in men with osteoporosis
• •Treating glucocorticoid-induced osteoporosis in men and women who take certain corticosteroid medicines and have low bone mineral density
• •Treating Paget's disease of bone in men and women

How it works

The label describes alendronate as a bisphosphonate that acts as a specific inhibitor of osteoclast-mediated bone resorption. In plain terms, it slows the process that breaks down bone, and it binds to hydroxyapatite, a mineral found in bone. The label states that it increases bone mass and reduces the incidence of fractures in postmenopausal women.

How it is usually taken

• •The label says alendronate works only when taken on an empty stomach. People are usually told to take it after getting up for the day and before their first food, drink, or other medicine, with a full glass (6 to 8 ounces) of plain water only. Other drinks such as mineral water, coffee, tea, soda, or juice should not be used. The tablet should be swallowed whole, not chewed or sucked. Take it while sitting or standing, and do not lie down for at least 30 minutes afterward or until after you eat. The label describes both a once-a-day and a once-a-week schedule. Follow the schedule your prescriber or pharmacist gives you.

Comes as

• •5 mg tablets (round, white to off-white)
• •10 mg tablets (oval, white to off-white)
• •35 mg tablets (oval, white to off-white)
• •70 mg tablets (oval, white to off-white)

⚠️ Alendronate side effects

🛑 Who should not take Alendronate, and who should be careful

The label says not to take it if

• 🚨You have certain problems with your esophagus that delay emptying, such as a stricture or achalasia.
• 🚨You cannot stand or sit upright for at least 30 minutes.
• 🚨You have low levels of calcium in your blood.
• 🚨You are allergic to alendronate or any of its ingredients.

Tell your doctor before taking it if

• •Tell your doctor if you have problems with swallowing, stomach or digestive problems, or trouble with your esophagus.
• •Tell your doctor if you have low blood calcium, which must be treated before you start. The label says it may get worse during treatment.
• •Tell your doctor if you have kidney problems, or if you have been told you have trouble absorbing minerals in your stomach or intestines (malabsorption syndrome).
• •Tell your doctor if you plan to have dental surgery or have teeth removed.
• •Tell your doctor if you are pregnant, may be pregnant, or are trying to become pregnant.
• •Tell your doctor if you are breastfeeding or plan to breastfeed.
• •Your doctor should examine your mouth before you start, and may ask you to see your dentist first.
• •The label says alendronate is not for use in children.
• •Keep a list of all your medicines, including vitamins and herbal supplements, and show it to your doctor and pharmacist.

🔀 Alendronate with other medicines, food and alcohol

The label says to discuss these with your doctor or pharmacist

• •Calcium supplements, antacids, and some oral medicines containing multivalent cations can interfere with how well alendronate is absorbed. The label says to wait at least one-half hour after taking alendronate before taking any other oral medicine.
• •Aspirin-containing products may increase upper gastrointestinal side effects. The label says to use caution.
• •Nonsteroidal anti-inflammatory drugs (NSAIDs) can cause stomach irritation. The label says caution should be used when they are taken with alendronate.
• •Tell your doctor about all prescription and non-prescription medicines, vitamins, and herbal supplements you take, because certain medicines may affect how alendronate works.

Alcohol and food

The label does not discuss alcohol. It does say that alendronate works only on an empty stomach, and that other beverages, food, and some medicines are likely to reduce how much of the medicine is absorbed. Take it before your first food, drink, or medicine of the day, with plain water only.

🤰 Alendronate in pregnancy and breastfeeding

Pregnancy

The label says there is not enough data on use in pregnant women to know the risk. It says to discontinue alendronate when pregnancy is recognized, and that it is not known whether it can harm an unborn baby. The label also reports animal studies that showed effects on offspring at certain doses. If you become pregnant while taking it, the label says to stop taking it and contact your doctor.

Breastfeeding

The label says it is not known whether alendronate passes into human breast milk or whether it may affect a breastfed baby. It says the benefits of breastfeeding should be weighed along with the mother's need for the medicine and possible effects on the child.

🗓️ Storage, missed doses and taking too much

Storage

Store in a well-closed container at 20 to 25 degrees Celsius (68 to 77 degrees Fahrenheit). The label allows brief temperature changes between 15 and 30 degrees Celsius (59 and 86 degrees Fahrenheit).

If a dose is missed

The label does not say.

If too much is taken

The label says there is no specific treatment information for overdose with alendronate. Overdose may cause low calcium, low phosphate, and stomach or esophagus problems such as upset stomach, heartburn, esophagitis, gastritis, or ulcer. The label says milk or antacids may be given to bind the medicine. Vomiting should not be induced because of the risk of esophageal irritation, and the patient should remain fully upright. Dialysis would not be beneficial. Contact a doctor, poison center, or emergency service right away if an overdose is suspected.

🗒️ Questions to ask about Alendronate

• How should I time my tablet so it is taken on an empty stomach with plain water?
• What signs of low calcium should I watch for, and when should I call you?
• Should I have my mouth and teeth checked before I start, and do I need dental work first?
• Do I need calcium and vitamin D supplements while taking this medicine?
• How long should I plan to take alendronate, and how often will you review whether I still need it?
• What other medicines, including antacids, calcium, or pain relievers, should I avoid or space out from this medicine?

❓ Alendronate: frequently asked questions