Alendronate

alendronic acid, Fosamax, Fosavance, Binosto, alendronic acid oral solution

Alendronate is an osteoporosis medication prescribed to help strengthen your bones and reduce your risk of breaking a bone. It is available as a weekly tablet, effervescent tablet, or oral solution.

Alendronate is a 'bisphosphonate' - a group of medications that work by slowing down the cells that break down bone. Bisphosphonates are the most-commonly prescribed medication for people with osteoporosis and are often the first treatment option considered by your doctor.

Alendronate doesn't reduce the pain caused by broken bones. But don't worry - if you're experiencing pain after breaking a bone, there are medications and treatments for pain that can help you.

Who should take alendronate?

Alendronate is usually prescribed for postmenopausal women, men and occasionally younger women.

Alendronate doesn't suit everyone. It may not be the best treatment for you if:

  • you have Barrett’s oesophagus
  • you have severe kidney problems
  • you are pregnant or breast feeding
  • you have difficulty swallowing tablets

If you're prescribed alendronate

Be informed

Talk to your doctor about your medication, its side-effects and any risks. You can read the information on this page and in your patient information leaflet, so you know what to expect.

Our specialist nurse Helpline is here for you, if you have any questions or concerns.

When to take it

For both the tablet and oral solution, alendronate should be taken on an empty stomach so it can be absorbed properly.

Take it first thing, and wait at least 30 minutes before having any food, drink and any other medication, although you can have water if you wish.

It's also best to wait at least four hours after taking alendronate before taking a calcium supplement. Calcium can affect how the medication is absorbed.

How long to take it

Alendronate is generally prescribed long term, so you need to be happy it is the right option for you. 

To get the full benefits, alendronate should be taken regularly as instructed by your doctor or pharmacist.

It is recommended that your treatment is formally reviewed by your doctor after five years. The review checks that the benefit of your medication continues to outweigh any risks. After your review, you may be advised to continue taking the drug, pause your treatment for a while, or stop it altogether.

If you miss a dose

Missing the odd dose is unlikely to affect your overall bone health, but you should try to avoid it.

If you continually forget or struggle to take your medication, speak to your doctor about alternative treatment options. There may be something that suits you better.

Possible side effects

It’s unlikely you’ll experience any side effects. But if you do, they shouldn't last for long.

Known side effects include:

  • Inflamed food pipe, sore throat, swallowing difficulties or heartburn
  • Bone, joint or muscle pain
  • Diarrhoea
  • Constipation 
  • Headache
  • Inflammation in the eye, eye pain or disturbed vision

As research progresses, the list of known side effects may change. You can find more information on each side effect and how to reduce the symptoms in the alendronate factsheet. 

You may have seen other symptoms and side effects in your patient information leaflet. These side effects are listed because they were reported by patients in research trials, but it’s unclear if they were directly caused by alendronate. They were also reported by patients taking the placebo (dummy treatment).

If you experience side effects

It's perfectly natural to be concerned by side effects although, in most cases, they do pass. 

The best thing to do is speak to your doctor or pharmacist. They can assess if there's a better treatment for you. They can also help you work out whether alendronate is causing the symptoms, or if something else is the cause, such as another medication.

Health risks

There are some more-serious but very rare health conditions associated with alendronate:

  • Osteonecrosis of the jaw - when the mouth fails to heal quickly, usually following invasive dental procedures
  • Atypical (unusual) broken bones in the thigh - a break to the thigh bone that occurs with little or no force after taking the medication for a long time

If you are prescribed alendronate, your doctor has decided the benefit of taking the treatment outweighs any risks.

It's perfectly natural to feel concerned and unsure, but be reassured that your risk of these is very small. Our specialist nurses are here for you, if you need to talk through your concerns and find out more about your risk.