Binosto

Generic Name: alendronate (a LEN dro nate)
Brand Name: Binosto, Fosamax

What is Binosto?

Binosto (alendronate) belongs to a group of medicines called bisphosphonates (bis FOS fo nayts). It alters the cycle of bone formation and breakdown in the body. Alendronate slows bone loss while increasing bone mass, which may prevent bone fractures.

Binosto effervescent tablet are used in men and women to treat or prevent osteoporosis that is caused by menopause or by taking steroids. Binosto is also used to increase bone mass in men who have osteoporosis.

Binosto may also be used for purposes not listed in this medication guide.

Important information about Binosto

Do not take a Binosto effervescent tablet if you cannot sit upright or stand for at least 30 minutes. Alendronate can cause serious problems in the stomach or esophagus (the tube that connects your mouth and stomach). You will need to stay upright for at least 30 minutes after taking Binosto.

Take the Binosto effervescent tablet first thing in the morning, at least 30 minutes before you eat or drink anything or take any other medicine.

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For at least the first 30 minutes after taking a Binosto effervescent tablet, do not lie down or recline; do not eat or drink anything other than plain water; and do not take any other medicines including vitamins, calcium, or antacids.

Some people using medicines similar to Binosto have developed bone loss in the jaw, also called osteonecrosis of the jaw. Symptoms may include jaw pain, swelling, numbness, loose teeth, gum infection, or slow healing after injury or surgery involving the gums. You may be more likely to develop osteonecrosis of the jaw if you have cancer or have been treated with chemotherapy, radiation, or steroids. Other conditions associated with osteonecrosis of the jaw include blood clotting disorders, anemia (low red blood cells), and a pre-existing dental problem.

If you need to have any dental work (especially surgery), tell the dentist ahead of time that you are using Binosto. You may need to stop using the medicine for a short time.

Talk with your doctor about the risks and benefits of using this medication.

Before taking Binosto

Do not take an Binosto tablet if you cannot sit upright or stand for at least 30 minutes. Alendronate can cause serious problems in the stomach or esophagus (the tube that connects your mouth and stomach). You will need to stay upright for at least 30 minutes after taking this medication.

You should not take Binosto if you are allergic to alendronate, or if you have low levels of calcium in your blood (hypocalcemia), or a problem with the movement of muscles in your esophagus.

To make sure you can safely take Binosto, tell your doctor if you have any of these other conditions:

• trouble swallowing;

• a vitamin D deficiency;

• a dental problem;

• kidney disease; or

• an ulcer or other problem in your stomach or esophagus.

Some people using medicines similar to Binosto have developed bone loss in the jaw, also called osteonecrosis of the jaw. Symptoms may include jaw pain, swelling, numbness, loose teeth, gum infection, or slow healing after injury or surgery involving the gums.

You may be more likely to develop osteonecrosis of the jaw if you have cancer or have been treated with chemotherapy, radiation, or steroids. Other conditions associated with osteonecrosis of the jaw include blood clotting disorders, anemia (low red blood cells), and dental surgery or pre-existing dental problems.

Talk with your doctor about the risks and benefits of using this medication.

FDA pregnancy category C. It is not known whether Binosto will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using Binosto.

See also: Binosto pregnancy and breastfeeding warnings (in more detail)

It is not known whether alendronate passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take Binosto?

Take Binosto exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Take Binosto after you get up for the day and 30 minutes before taking your first food, drink, or other medicine. Do not swallow, chew or suck on the tablet. Follow the directions on your prescription label.

Binosto is taken once a week. Choose the day of the week that best fits your schedule, then take the effervescent tablet on the same day every week.

To use the Binosto effervescent tablet, dissolve the tablet in at least 4 ounces of plain water at room temperature. Wait at least 5 minutes after the bubbling (effervescence) stops for the tablet to completely dissolve in the water. Stir the liquid medicine for about 10 seconds. Drink all of the Binosto liquid medicine in the glass. To make sure you get the entire dose, add a little more water to the same glass, swirl gently and drink right away. Do NOT dissolve Binosto in mineral or flavored water, coffee, tea, soda, or juice.

After taking Binosto, carefully follow these instructions:

• Do not lie down or recline for at least 30 minutes after taking the effervescent tablet.

• Do not eat or drink anything other than plain water. Binosto works only if you take it on an empty stomach.

• Do not take any other medicines including vitamins, calcium, or antacids for at least 30 minutes after taking Binosto. It may be best to take your other medicines at a different time of the day. Talk with your doctor about the best dosing schedule for your other medicines.

To be sure this medication is helping your condition, your bone mineral density will need to be tested on a regular basis. You may not need to take Binosto for longer than 3 to 5 years if you take it for osteoporosis. Visit your doctor regularly.

If you need to have any dental work (especially surgery), tell the dentist ahead of time that you are using Binosto. You may need to stop using the medicine for a short time.

Binosto is only part of a complete program of treatment that may also include diet changes, exercise, and taking calcium and vitamin supplements. Follow your diet, medication, and exercise routines very closely.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

If you forget to take Binosto on your scheduled day, take it first thing in the morning on the day after you remember the missed dose. Then return to your regular weekly schedule on your chosen dose day. Do not take two (2) tablets in one day.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Drink a full glass of milk and call your local poison control center or emergency room right away. Do not make yourself vomit and do not lie down.

Overdose symptoms may include nausea, heartburn, stomach pain, diarrhea, muscle cramps, numbness or tingling, tight muscles in your face, seizure (convulsions), irritability, and unusual thoughts or behavior.

What should I avoid while taking Binosto?

Binosto contains a high amount of salt in each tablet. Avoid eating foods with a high amount of salt if your doctor has told you to limit how much salt you eat.

Avoid taking any other medicines including vitamins, calcium, or antacids for at least 30 minutes after taking Binosto. Some medicines can make it harder for your body to absorb Binosto.

Do not lie down for at least 30 minutes after you take a Binosto tablet.

Binosto side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Binosto: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using Binosto and call your doctor at once if you have a serious side effect such as:

• chest pain;

• difficulty or pain when swallowing;

• pain or burning under the ribs or in the back;

• severe heartburn, burning pain in your upper stomach, or coughing up blood;

• new or worsening heartburn;

• fever, body aches, flu symptoms;

• severe joint, bone, or muscle pain;

• new or unusual pain in your thigh or hip;

• jaw pain, numbness, or swelling.

Less serious Binosto side effects may include:

• mild heartburn, bloating;

• mild nausea, vomiting, or stomach pain;

• diarrhea, gas, or constipation;

• mild joint pain or swelling;

• swelling in your hands or feet; or

• dizziness, eye pain, headache.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Binosto side effects (in more detail)

What other drugs will affect Binosto?

Tell your doctor about all other medicines you use, especially aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as:

• celecoxib (Celebrex);

• diclofenac (Arthrotec, Cambia, Cataflam, Voltaren, Flector Patch, Pennsaid, Solareze);

• diflunisal (Dolobid);

• ibuprofen (Motrin, Advil);

• indomethacin (Indocin);

• ketoprofen (Orudis)

• ketorolac (Toradol);

• meloxicam (Mobic);

• naproxen (Aleve, Naprosyn, Naprelan, Treximet); or

• piroxicam (Feldene).

This list is not complete and other drugs may interact with Binosto. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about Binosto.