Alendronate Sodium Side Effects, Precautions, and Other Important Information

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Also known as Fosamax, this medication is used to treat and prevent osteoporosis. It is in the bisphosphonates class of medications. This medication class helps to prevent bone loss by reducing the activity of cells that are responsible for breaking down bone. Alendronate sodium side effects and precautions are something all patients taking this medication should familiarize themselves with.

How is this Medication Used?

This medication is taken once daily, orally. Patients should take it first thing in the morning before taking any other medications, or eating or drinking, unless their doctor instructs them otherwise. It should be taken with at least six ounces of plain water. Once the patient takes this pill, they should not lie down and must remain upright for a minimum of thirty minutes. Patients should wait a minimum of thirty minutes, though one to two hours is preferable, before eating or drinking anything, but plain water. This medication cannot be taken at bedtime or before waking up for the day. Patients must wait at least thirty minutes, and preferably one to two hours, before taking any other medications, supplements, herbs, or vitamins.

Side Effects

It is common for patients to experience constipation, gas, stomach pain, and nausea when taking this medication, but these most often subside once the body gets used to it. The serious alendronate sodium side effects often require immediate medical attention and must also be reported to the patient’s doctor as soon as possible. These include:

  • Jaw pain
  • Swelling in the hands, feet, joints, and ankles
  • Coffee ground-looking vomit
  • Esophageal ulcers
  • Esophageal irritation
  • Bone and muscle pain increase
  • Black stools
  • Worsening or new heartburn
  • Painful or difficult swallowing
  • Chest pain


In some cases, this medication will be contraindicated. Such cases include having the following medical conditions and disorders:

  • Bisphosphonates articles
  • Certain other allergies
  • Any esophageal disorder
  • Not being able to sit upright or stand for a at least thirty minutes
  • Severe kidney disease
  • Low calcium levels
  • History of difficulty swallowing
  • Intestinal and stomach disorders
  • Cancer
  • Blood-clotting disorders
  • Poor dental hygiene
  • Previous radiation therapy
  • Anemia
  • Mouth diseases or infections

Drug Interactions

Some medications interact with others. Fosamax drug interactions include:

  • Prednisone and other corticosteroids
  • Chemotherapy, specifically for cancer
  • Aspirin
  • Naproxen
  • Ibuprofen
  • Non-steroidal anti-inflammatory drugs
  • Low-dose aspirin unless the patient’s doctor says it is alright to take it

Warnings and Precautions

Alendronate sodium precautions should be heeded by all patients. Though infrequent, osteonecrosis, a serious jawbone problem can occur in patients using similar medications. Children should not take this medication because they can experience severe side effects, such as fever, vomiting, and flu-like symptoms. Those who are trying to conceive or already pregnant should avoid this medication. This medication should also be avoided when breastfeeding.

RxList. (2010). Fosamax. Retrieved on September 1, 2010 from RxList: (2010). Fosamax. Retrieved on September 1, 2010 from