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alendronate

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

What is alendronate?

Alendronate is a bisphosphonate (bis FOS fo nayt) medicine that alters bone formation and breakdown in the body. This can slow bone loss and may help prevent bone fractures.

Alendronate is used in men and women to treat or prevent osteoporosis caused by menopause or by taking steroids. Alendronate is also used to increase bone mass in men who have osteoporosis, and to treat Paget's disease of bone in men and women.

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

What is the most important information I should know about alendronate?

You should not take alendronate if you have problems with your esophagus, or low levels of calcium in your blood.

Do not take alendronate if you cannot sit upright or stand for at least 30 minutes after taking the medicine.

Alendronate can cause serious problems in the stomach or esophagus. Stop using alendronate and call your doctor at once if you have chest pain, new or worsening heartburn, or pain when swallowing.

Also call your doctor if you have muscle spasms, numbness or tingling (in hands and feet or around the mouth), new or unusual hip pain, or severe pain in your joints, bones, or muscles.

What should I discuss with my healthcare provider before taking alendronate?

You should not take alendronate if you are allergic to it, or if you have:

  • low levels of calcium in your blood (hypocalcemia); or

  • problems with the muscles in your esophagus (the tube that connects your mouth and stomach).

Do not take alendronate if you cannot sit upright or stand for at least 30 minutes. Alendronate can cause serious problems in the stomach or esophagus. You must stay upright for at least 30 minutes after taking this medicine.

To make sure alendronate is safe for you, tell your doctor if you have ever had:

  • trouble swallowing;

  • problems with your stomach or digestion;

  • hypocalcemia;

  • a dental problem (you may need a dental exam before you begin taking alendronate);

  • kidney disease; or

  • any condition that makes it hard for your body to absorb nutrients from food (malabsorption).

The effervescent tablet contains a lot of sodium. Tell your doctor if you are on a low-salt diet before using this form of alendronate.

In rare cases, this medicine may cause bone loss (osteonecrosis) in the jaw. Symptoms include jaw pain or numbness, red or swollen gums, loose teeth, or slow healing after dental work. The longer you use alendronate, the more likely you are to develop this condition.

Osteonecrosis of the jaw may be more likely if you have cancer or received chemotherapy, radiation, or steroids. Other risk factors include blood clotting disorders, anemia (low red blood cells), and a pre existing dental problem.

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

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether alendronate passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

How should I take alendronate?

Alendronate is taken either once daily or once per week. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Take alendronate first thing in the morning, at least 30 minutes before you eat or drink anything or take any other medicine. If you take alendronate only once per week, take it on the same day each week and always first thing in the morning.

Take with a full glass (6 to 8 ounces) of plain water. Do not use coffee, tea, soda, juice, or mineral water. Do not eat or drink anything other than plain water.

Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

Do not crush, chew, or suck on an alendronate regular tablet. Swallow it whole.

Dissolve the effervescent tablet in at least 4 ounces of water (at room temperature, not hot or cold). Let the tablet dissolve for 5 minutes. Stir this mixture for 10 seconds and drink all of it right away. Add a little more water to the glass, swirl gently and drink right away.

For at least 30 minutes after taking alendronate:

  • Do not lie down or recline.

  • Do not take any other medicine including vitamins, calcium, or antacids.

Pay special attention to your dental hygiene while taking alendronate. Brush and floss your teeth regularly. If you need to have any dental work (especially surgery), tell the dentist ahead of time that you are using alendronate.

Alendronate is only part of a complete program of treatment that may also include diet changes, exercise, bone mineral density testing, and taking calcium and vitamin supplements. Follow your doctor's instructions very closely.

Store at room temperature away from moisture and heat. Keep unused effervescent tablets in the foil blister pack.

Your doctor will determine how long to treat you with this medicine. Alendronate is often given for only 3 to 5 years.

What happens if I miss a dose?

Once-daily dosing: If you forget to take alendronate first thing in the morning, do not take it later in the day. Wait until the following morning and skip the missed dose. Do not take two (2) doses in one day.

Once-per-week dosing: If you forget to take alendronate 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 2 doses in one day.

What happens if I overdose?

Drink a full glass of milk and seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Do not make yourself vomit and do not lie down.

What should I avoid while taking alendronate?

Avoid taking any other medicines for at least 30 minutes after taking alendronate. This includes vitamins, calcium, and antacids. Some medicines can make it harder for your body to absorb alendronate.

Avoid smoking, or try to quit. Smoking can reduce your bone mineral density, making fractures more likely.

Avoid drinking large amounts of alcohol. Heavy drinking can also cause bone loss.

Alendronate side effects

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

Stop using alendronate and call your doctor at once if you have:

  • chest pain, new or worsening heartburn;

  • 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 unusual pain in your thigh or hip;

  • jaw pain, numbness, or swelling;

  • severe joint, bone, or muscle pain; or

  • low calcium levels--muscle spasms or contractions, numbness or tingly feeling (around your mouth, or in your fingers and toes).

Common side effects may include:

  • heartburn, upset stomach;

  • stomach pain, nausea;

  • diarrhea, constipation; or

  • bone pain, muscle or joint pain.

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.

Side Effects (complete list)

Alendronate dosing information

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

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

Uses:
-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

Comments:
-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

Comments:
-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

What other drugs will affect alendronate?

Tell your doctor about all your current medicines and any you start or stop using, especially:

  • aspirin; or

  • NSAIDs (nonsteroidal anti-inflammatory drugs)--ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

This list is not complete. Other drugs may interact with alendronate, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. Talk with your doctor about the best dosing schedule for your other medicines.

Where can I get more information?

  • Your pharmacist can provide more information about alendronate.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 12.02.

Last reviewed: November 08, 2017
Date modified: December 03, 2017

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