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All about: Fosamax

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Generic name: Alendronate sodium
Brand names: Fosamax

Why is Fosamax prescribed?

Fosamax is prescribed for the prevention and treatment of osteoporosis, the brittle bone disease, in postmenopausal women. It is also used to increase bone mass in men with osteoporosis, and is prescribed for both men and women who have developed a form of osteoporosis sometimes caused by steroid medications such as prednisone. This drug can also be used to relieve Paget's disease of bone, a painful condition that weakens and deforms the bones.

Most important fact about Fosamax

For Fosamax to be effective, you must take the tablets without food or other medications, exactly as directed.

How should you use medication?

Fosamax is effective only when each tablet or bottle of oral solution is taken with a full glass of plain water first thing in the morning, at least 30 minutes before the first food, beverage, or other medication. If you can wait longer before eating or drinking, the medication will be absorbed better. Do not lie down after taking Fosamax until at least 30 minutes have passed and you've had something to eat.

Avoid chewing or sucking on the tablet; it can cause mouth sores.

You should take calcium and vitamin D supplements if you don't get enough in your diet. Avoid smoking and alcohol. Weight-bearing exercise can also strengthen bones.

--If you miss a dose...

If you are taking Fosamax on a daily basis, do not take a missed dose later in the day, Instead, skip it and go back to your regular schedule the next morning.

If you are taking Fosamax once a week, take 1 tablet or 1 bottle of oral solution the morning after you remember, then return to your original once-weekly schedule on the chosen day. Do not take 2 doses on the same day.

--Storage instructions...

Keep the container tightly closed and store at room temperature. Do not freeze the oral solution.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue using Fosamax.

  • More common side effects may include:
    Abdominal pain, Acid regurgitation, bone and joint pain, constipation, diarrhea, gas, indi­gestion, muscle pain, nausea

Why should Fosamax not be prescribed?

You should not take Fosamax if the calcium level in your blood is low. Avoid Fosamax if it causes an allergic reaction.

You will not be able to take Fosamax if you are unable to stand or sit upright for at least 30 minutes. You must also avoid the drug if your esophagus is not working properly due to strictures or achalasia (a swallowing disorder).

If you're prone to swallowing air or choking when you drink something, you should not use the oral solution.

Special warnings about Fosamax

Fosamax is not recommended for women on hormone replacement therapy, or for women with kidney problems.

Be sure to tell your doctor if you have trouble swallowing or have any digestive problems, including heartburn or ulcers. Fosamax may cause problems in your esophagus such as inflammation, ulcers, bleeding, and in rare cases, blockage or perforation.

Possible food and drug interactions when taking Fosamax

Combining aspirin with a Fosamax dose of more than 10 milligrams per day will increase the likelihood of stomach upset.

Calcium supplements such as Caltrate, antacids such as Riopan, and some other oral medications will interfere with the absorption of Fosamax, so wait at least 30 minutes after taking Fosamax before you take anything else.

Special information if you are pregnant or breastfeeding

The effects of Fosamax during pregnancy and breastfeeding have not been adequately studied. If you are pregnant or plan to become pregnant, notify your doctor immediately. It is not known whether Fosamax appears in breast milk. The drug is not recommended for nursing mothers.

Recommended dosage


The usual dose is one 10-milligram tablet once a day, or one 70-milligram tablet or bottle of oral solution once a week. Treatment continues for years.


The usual dose is one 5-milligram tablet once a day or one 35-milligram tablet once a week.


The usual dose is one 10-milligram tablet once a day, or one 70-milligram tablet or bottle of oral solution once a week.


The usual dose is one 5-milligram tablet once a day, except for postmenopausal women not taking estrogen, who should take one 10-milligram tablet once daily.


The usual dose is 40 milligrams once a day for 6 months.


Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.

  • Symptoms of Fosamax overdose may include:
    Heartburn, inflammation of the esophagus or stomach, ulcer, upset stomach

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