Fosamax (alendronate) belongs to a group of medicines called bisphosphonates (bis FOS fo nayts). It alters the cycle of bone formation and breakdown in the body. Alendronate slows bone loss while increasing bone mass, which may prevent bone fractures.
Fosamax is used in women to treat or prevent osteoporosis that is caused by menopause and in men and women to treat osteoporosis caused by taking steroids.
Fosamax is also used to increase bone mass in men who have osteoporosis, and to treat Paget"s disease of bone in men and women.
Important information
You should not take Fosamax if you have low levels of calcium in your blood (hypocalcemia), or a problem with the movement of muscles in your esophagus.
Do not take a Fosamax tablet if you cannot sit upright or stand for at least 30 minutes after taking the medicine.
Before taking this medicine
You should not take Fosamax if you are allergic to alendronate, or if you have low levels of calcium in your blood (hypocalcemia), or a problem with the movement of muscles in your esophagus.
Do not take a Fosamax tablet if you cannot sit upright or stand for at least 30 minutes. Alendronate can cause serious problems in the stomach or esophagus (the tube that connects your mouth and stomach). You will need to stay upright for at least 30 minutes after taking this medication.
To make sure Fosamax is safe for you, tell your doctor if you have:
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 Fosamax, 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 Fosamax will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.
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 Fosamax?
Take Fosamax exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.
Fosamax tablets are taken either once each day or once each week.
Take the tablet first thing in the morning, at least 30 minutes before you eat or drink anything or take any other medicine. If you take a tablet only once a week, take it on the same day each week and always first thing in the morning.
Take Fosamax with a full glass (6 to 8 ounces) of water. Use only plain water (not mineral water) when taking the tablet.
Do not crush, chew, or suck a tablet. Swallow the pill whole.
After taking Fosamax, carefully follow these instructions:
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Do not lie down or recline for at least 30 minutes after taking Fosamax.
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Do not eat or drink anything other than plain water.
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Do not take any other medicines including vitamins, calcium, or antacids for at least 30 minutes after taking Fosamax. It may be best to take your other medicines at a different time of the day. Talk with your doctor about the best dosing schedule for your other medicines.
To be sure this medication is helping your condition, your bone mineral density will need to be tested on a regular basis. You may not need to take this medicine for longer than 3 to 5 years if you take it for osteoporosis. Visit your doctor regularly.
If you need to have any dental work (especially surgery), tell the dentist ahead of time that you are using alendronate. You may need to stop using the medicine for a short time.
Fosamax is only part of a complete program of treatment that may also include diet changes, exercise, and taking calcium and vitamin supplements. Follow your diet, medication, and exercise routines very closely.
Store at room temperature away from moisture and heat.
What happens if I miss a dose?
If you take Fosamax once daily: If you forget to take this medicine first thing in the morning, do not take it later in the day. Wait until the following morning to take the medicine and skip the missed dose. Do not take two (2) tablets in one day.
If you take Fosamax once a week: If you forget to take your dose 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 two (2) tablets in one day.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Drink a full glass of milk and call your local poison control center or emergency room right away. Do not make yourself vomit and do not lie down.
Overdose symptoms may include nausea, heartburn, stomach pain, diarrhea, muscle cramps, numbness or tingling, tight muscles in your face, seizure (convulsions), irritability, and unusual thoughts or behavior.
What should I avoid?
Avoid taking any other medicines including vitamins, calcium, or antacids for at least 30 minutes after taking Fosamax. Some medicines can make it harder for your body to absorb Fosamax.
Fosamax side effects
Get emergency medical help if you have any signs of an allergic reaction to Fosamax: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Stop using Fosamax and call your doctor at once if you have:
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chest pain, new or worsening heartburn;
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difficulty or pain when swallowing;
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pain or burning under the ribs or in the back;
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severe heartburn, burning pain in your upper stomach, or coughing up blood;
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new or worsening heartburn;
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severe joint, bone, or muscle pain, new or unusual pain in your thigh or hip;
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fever, body aches, flu symptoms; or
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jaw pain, numbness, or swelling.
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new or unusual pain in your thigh or hip;
Common Fosamax side effects may include:
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mild heartburn, bloating;
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mild nausea, vomiting, or stomach pain;
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diarrhea, gas, or constipation;
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mild joint pain or swelling;
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swelling in your hands or feet; or
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dizziness, eye pain, headache.
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.
See also: Side effects (in more detail)
What other drugs will affect Fosamax?
Tell your doctor about all medicines you use, and those you start or stop using during your treatment with Fosamax, especially:
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levothyroxine (Synthroid, Levothroid, and others); or
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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.
