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Alendronate Dosage

Medically reviewed by Last updated on Dec 4, 2017.

Applies to the following strengths: 70 mg; 35 mg; 40 mg; 5 mg; 10 mg; 70 mg/75 mL

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 or
-70 mg orally once a week

Treatment of Glucocorticoid-Induced Osteoporosis:
-5 mg orally once a day or
-10 mg orally once a day in postmenopausal women not receiving estrogen

-Refer to administration advice for details on how to take this drug.
-Reevaluate bisphosphonate therapy periodically.

-Treatment to increase bone mass and reduce the incidence of fractures including hip and spine (vertebral compression fractures) in postmenopausal women with osteoporosis
-Treatment to increase bone mass in men with osteoporosis
-Treatment of glucocorticoid-induced osteoporosis in men and women receiving glucocorticoids in a daily dosage equivalent to 7.5 mg or greater of prednisone and who have low bone mineral density

Usual Adult Dose for Prevention of Osteoporosis

-5 mg orally once a day or
-35 mg orally once a week

-Refer to administration advice for details on how to take this drug.
-Reevaluate bisphosphonate therapy periodically.

Use: Prevention of osteoporosis in postmenopausal women

Usual Adult Dose for Paget's Disease

-40 mg orally once a day for six months

-Retreatment may be considered, following a six- month post-treatment evaluation period in patients who have relapsed, based on increases in serum alkaline phosphatase measured periodically.
-Retreatment may also be considered in patients who failed to normalize serum alkaline phosphatase.

Use: Treatment of Paget's disease of bone

Renal Dose Adjustments

CrCl 35 mL/min or more: No adjustment recommended.
CrCl less than 35 mL/min: Not recommended.

Liver Dose Adjustments

No adjustment recommended.


Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.


Data not available

Other Comments

Administration advice:
Instructions to assure adequate drug absorption and to decrease the risk of esophageal adverse reactions:
-Take this drug on an empty stomach, with a full glass of water (6 to 8 ounces), upon arising for the day, and at least 30 minutes before the first food, beverage, or medication of the day.
-Avoid lying down for at least 30 minutes after taking this drug and until after the first food of the day.
-This drug should not be taken with mineral water, coffee, tea, soda, or juice.
-This drug should not be taken at bedtime or before arising for the day.
-The oral solution should be followed by at least 2 ounces of water to facilitate gastric emptying.
-Dissolve effervescent tablets in 4 ounces of plain room temperature water. After effervescence stops, wait 5 minutes, then stir solution for 10 seconds, and ingest.
-Waiting less than 30 minutes, or taking this drug with food, beverages (other than plain water) or other medications will decrease drug's absorption and lessen its therapeutic effect.

Recommendations for Calcium and Vitamin D Supplementation:
-Take supplemental calcium and vitamin D if dietary intake is inadequate.
-Patients at increased risk for vitamin D insufficiency (e.g., over the age of 70 years, nursing home-bound, or chronically ill) may need vitamin D supplementation.
-Patients with gastrointestinal malabsorption syndromes may require higher doses of vitamin D. supplementation and measurement of 25-hydroxyvitamin D should be considered.
-Patients treated with glucocorticoids should receive adequate amounts of calcium and vitamin D.

Administration Instructions for Missed Doses:
-If the once-weekly dose is missed, take one dose on the morning after remembering; two doses should not be taken on the same day.
-Resume the next dose on its regular schedule.

Limitations of Use:
-The optimal duration of use has not been determined.
-All patients on bisphosphonate therapy should be reevaluated for continued therapy on a periodic basis.
-Patients at low-risk for fracture should consider drug discontinuation after 3 to 5 years of use.
-Reevaluate risk for fractures periodically after discontinuing therapy.

-Metabolic: Serum calcium and symptoms of hypocalcemia

Patient advice:
-Allergic reactions, such as hives, swelling of face, lips, tongue, or throat may occur.
-Report any side effect that bothers or that does not go away.
-Failure to follow administration instructions for this drug may increase the risk of esophageal adverse reactions.
-Discontinue this drug and seek medical attention if dysphagia, odynophagia, retrosternal pain or new or worsening heartburn develop.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.