Alendronate - Use | Dose | Side Effects

This article was medically reviewed by M.Pharm, Marko Tanaskovic on Thu, 27 Dec 2018. To read more about an author, click here.

Alendronate is a drug from the group of bisphosphonates. It prevents the loss of bone mass and is therefore used to treat and prevent osteoporosis. Osteoporosis is a bone disease characterized with a gradual loss of bone mass that makes bones easy to break. The risk of osteoporosis is greater in menopausal women and after use of certain medicines (such as corticosteroids), so Alendronate may be used then.


It should be avoided in the following conditions:

  • If you are allergic to Alendronate or other similar medicines. Symptoms of allergy are:
    • skin rash,
    • itching of the skin,
    • redness of the skin,
    • swelling of the throat,
    • swelling of the tongue,
    • trouble breathing. Immediately contact your doctor if you are experiencing these symptoms.
  • Esophagus or throat damage. Alendronate can further damage your esophagus, especially if the medicine is retained for a long time in the esophagus.
  • If you have low calcium levels in the blood (hypocalcemia)
  • Vitamin D deficiency
  • If you have kidney disorders.
  • If you plan to go to dentist, inform your dentist that you are taking this medicine.

Do not lie down or sit at least half an hour after taking this medicine. You should stand up or walk. If you are lying or sitting, it will remain in the esophagus for a long time and may cause damage to your esophagus. Alendronate should be taken with at least one glass of water (250 ml).

It should not be used in combination with alcoholic beverages.

Use during pregnancy and breastfeeding

According to FDA, Alendronate belongs to a group C (FDA: Group C). This means that animal studies have shown adverse effect on fetus, but there are no studies on humans. It should be used during pregnancy only if the benefit to the mother outweighs the risk to the child.

There are no data whether Alendronate passes into breast milk. Consult your doctor about using this medicament during breastfeeding.

Use and Dose

It should be taken with at least one glass of water (250 ml). After you take a pill, do not you lie down or sit down for half an hour. You should walk or stand up. This will reduce the risk of esophagus damage.

It should not be taken at bedtime! It also should be taken in the morning on an empty stomach. If you forgot to take in the morning, do not take it later in the day. Wait until the next morning.

After drinking this drug, you should not take any food or drink (except plain water) or other medicines (including vitamins) for an hour. Food, beverages and other medications can slow the absorption of Alendronate tablet and reduce its effect.

Alendronate is usually taken over long periods of time (at least 3 years).


Condition Dose
Prevention of osteoporosis 35 mg once a week or 5 mg daily
Treatment of osteoporosis Alendronate 70 mg once a week or 10 mg daily
Paget's disease 40 mg once a day


If you take more Alendronate than your doctor tells you to, following symptoms may occur:

  1. nausea,
  2. vomiting,
  3. diarrhea,
  4. numbness,
  5. seizures.

If you take more than your doctor tells you to, contact your doctor.

Use with other medicines (Interactions)

Alendronate sodium should not be taken in combination with the following medications:

  • Non-steroidal anti-inflammatory medicines used for pain and rheumatic conditions treatment, such as:
    • ibuprofen (Brufen),
    • diclofenac (Diklofen),
    • ketoprofen,
    • flurbiprofen,
    • meloxicam (Movalis),
    • indomethacin,
    • celecoxib,
    • rofecoxib and others.
  • Vitamin and mineral supplements.

Tell your doctor about all medications and herbal medicines you are taking.

After taking Alendronate you should not eat, drink (except plain water), or take other medicines for an hour, because food, beverages and medicines can reduce the effect of Alendronate.

Alendronate side effects

It can cause severe damage to the jaw (jaw osteonecrosis). This is characterized by loss of bone mass in the jaw, increasing the risk of jaw fracture. Immediately contact your doctor if you notice symptoms such as:

  1. jaw pain,
  2. jaw numbness,
  3. tooth loss. These symptoms suggest that jaw osteonecrosis has occurred. You should know that jaw osteonecrosis occurs very rarely.

Alendronate can also cause the following side effects:

  1. nausea,
  2. vomiting (vomiting may be accompanied by blood),
  3. diarrhea,
  4. constipation,
  5. stomach pain,
  6. heartburn,
  7. esophageal damage,
  8. painful swallowing,
  9. flu-like symptoms (cough, fever),
  10. muscle pain,
  11. chest pain,
  12. coughing up blood,
  13. allergy.

If you are experiencing any side effects, contact your doctor.

Information on this website are provided for educational purposes only and are not intended for medical advice, diagnosis or treatment.

If you have any concerns or questions about your health, you should always consult with a physician or other health-care professional.