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Alendronate Side Effects

Not all side effects for alendronate may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

For the Consumer

Applies to alendronate: oral solution, oral tablet, oral tablet effervescent

In addition to its needed effects, some unwanted effects may be caused by alendronate. In the event that any of these side effects do occur, they may require medical attention.

You should check with your doctor immediately if any of these side effects occur when taking alendronate:

More common
  • Abdominal or stomach pain
Less common
  • Difficulty with swallowing
  • heartburn
  • irritation or pain of the esophagus
  • muscle pain
  • Skin rash
Incidence not known
  • Abdominal or stomach cramps
  • blistering, peeling, or loosening of the skin
  • bloating or swelling of the face, arms, hands, lower legs, or feet
  • bone, joint, or muscle pain, severe and occasionally incapacitating
  • chest pain
  • chills
  • confusion
  • convulsions
  • cough
  • diarrhea
  • difficulty with breathing
  • difficulty with moving
  • heartburn
  • heavy jaw feeling
  • hives or welts
  • irregular heartbeats
  • itching
  • joint pain
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • loosening of a tooth
  • muscle aching or cramping
  • muscle cramps in the hands, arms, feet, legs, or face
  • numbness and tingling around the mouth, fingertips, or feet
  • pain or burning in the throat
  • pain, swelling, or numbness in the mouth or jaw
  • rapid weight gain
  • red skin lesions, often with a purple center
  • red, irritated eyes
  • redness of the skin
  • shortness of breath
  • sore throat
  • sores, ulcers, or white spots on the lips or tongue or inside the mouth
  • swollen joints
  • tingling of the hands or feet
  • tremor
  • unusual tiredness or weakness
  • unusual weight gain or loss
  • vomiting

Some of the side effects that can occur with alendronate may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

Less common
  • Constipation
  • diarrhea
  • full or bloated feeling
  • gas
  • headache
  • nausea
Incidence not known
  • Blurred vision or other change in vision
  • dizziness or lightheadedness
  • eye pain
  • feeling of constant movement of self or surroundings
  • general feeling of discomfort or illness
  • hair loss or thinning of the hair
  • sensation of spinning
  • sensitivity of the eye to light
  • tearing

For Healthcare Professionals

Applies to alendronate: oral solution, oral tablet, oral tablet effervescent


Generally, this drug has been well tolerated. Adverse effects usually have been mild when patients adhered to prescribing instructions.[Ref]


Very common (10% or more): Bone, muscle or joint pain (sometimes severe)
Common (1% to 10%): Muscle cramp, joint swelling
Rare (less than 0.1%): Osteonecrosis of the jaw, atypical subtrochanteric and diaphyseal femoral fractures
Postmarketing reports: Myalgia, low-energy femoral shaft and subtrochanteric fractures[Ref]


Common (1% to 10%): Alopecia, pruritus
Uncommon (0.1% to 1%): Rash, erythema
Rare (less than 0.1%): Rash with photosensitivity, severe skin reactions including Stevens-Johnson syndrome and toxic epidermal necrolysis[Ref]


Common (1% to 10%): Abdominal pain, dyspepsia, acid regurgitation, nausea, abdominal distension, constipation, diarrhea, flatulence, esophageal ulcer, gastritis, gastroesophageal reflux
Uncommon (0.1% to 1%): Gastric ulcer, esophagitis, esophageal erosions, melena, dysphagia, vomiting
Rare (less than 0.1%): Esophageal stricture, oropharyngeal ulceration, upper gastrointestinal PUB (perforation, ulcers, bleeding)
Postmarketing reports: Localized osteonecrosis of the jaw, generally associated with tooth extraction and/or local infection with delayed healing[Ref]

Nervous system

Common (1% to 10%): Headache, dizziness
Uncommon (0.1% to 1%): Dysgeusia[Ref]


Common (1% to 10%): Vertigo, asthenia, peripheral edema
Uncommon (0.1% to 1%): Transient symptoms of myalgia, malaise and rarely, typically in association with initiation of treatment[Ref]


Uncommon (0.1% to 1%): Eye inflammation (uveitis, scleritis, episcleritis)[Ref]


Rare (less than 0.1%): Symptomatic hypocalcemia (often in association with predisposing conditions)[Ref]


Rare (less than 0.1%): Urticaria, angioedema[Ref]


Postmarketing reports: Acute asthma exacerbations[Ref]


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