Also found in: Dictionary, Thesaurus, Wikipedia.

alendronate sodium

Apo-Alendronate (CA), Co Alendronate (CA), Dom-Alendronate (CA), Fosamax, Gen-Alendronate (CA), Ratio-Alendronate (CA), Sandoz Alendronate

Pharmacologic class: Bisphosphonate

Therapeutic class: Bone-resorption inhibitor

Pregnancy risk category C


Impedes bone resorption by inhibiting osteoclast activity, absorbing calcium phosphate crystal in bone, and directly blocking dissolution of hydroxyapatite crystal of bone


Tablets: 5 mg, 10 mg, 35 mg, 40 mg, 70 mg

Indications and dosages

Paget's disease of bone (men and women)

Adults: 40 mg P.O. daily for 6 months

Prevention of osteoporosis in postmenopausal women

Adults: 5 mg P.O. daily or 35 mg P.O. once weekly for up to 7 years

Glucocorticoid-induced osteoporosis in men and women

Adults: 5 mg P.O. daily. For postmenopausal women not receiving estrogen, recommended dosage is 10 mg P.O. once daily.

Treatment of osteoporosis in postmenopausal women; treatment to increase bone mass in men with osteoporosis

Adults: 70-mg tablet or 70 mg oral solution P.O. weekly or 10-mg tablet P.O. daily


• Hypersensitivity to drug or its components

• Hypocalcemia

• Esophageal abnormalities such as stricture or achalasia that delay esophageal emptying

• Inability to stand or sit upright for 30 minutes

• Increased risk of aspiration (oral solution)


Use cautiously in:

• Severe renal insufficiency (creatinine clearance less than 35 ml/minute), esophageal disease, GI ulcers, gastritis, osteonecrosis of jaw

• pregnant or breastfeeding patients

• children.


• Give with 6 to 8 oz of water 30 minutes before first food, beverage, or medication of day.

• Don't give at bedtime or before patient arises for the day.

• Don't give food, other beverages, or oral drugs for at least 30 minutes after giving tablets.

• Keep patient upright for at least 30 minutes after giving dose to avoid serious esophageal irritation.

• Follow oral solution with at least 60 ml (2 oz) of water to facilitate gastric emptying.

• Be aware that patients should receive supplemental calcium and vitamin D if dietary intake is inadequate.

• Be aware that aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) may worsen GI upset. Discuss alternative analgesics with prescriber.

Adverse reactions

CNS: headache

CV: hypertension

GI: nausea, vomiting, diarrhea, constipation, abdominal pain, acid regurgitation, esophageal ulcer, flatulence, dyspepsia, abdominal distention, dysphagia

GU: urinary tract infection

Hematologic: anemia

Metabolic: hypomagnesemia, hypophosphatemia, hypokalemia, fluid overload

Musculoskeletal: bone or muscle pain

Skin: rash, redness, photosensitivity

Other: abnormal taste


Drug-drug. Antacids, calcium supplements: decreased alendronate absorption

NSAIDs, salicylates: increased risk of GI upset

Ranitidine: increased alendronate effect

Drug-diagnostic tests. Calcium, phosphate: decreased levels

Drug-food. Any food, caffeine (as in coffee, tea, cocoa), mineral water, orange juice: decreased drug absorption

Patient monitoring

• Monitor for signs and symptoms of GI irritation, including ulcers.

• Monitor blood pressure.

• Evaluate blood calcium and phosphate levels.

Patient teaching

Tell patient to immediately report serious vomiting, severe chest or abdominal pain, difficulty swallowing, or abdominal swelling.

• Instruct patient to take tablets first thing in the morning on an empty stomach, with 6 to 8 oz of water only.

• Instruct patient to follow oral solution with at least 60 ml (2 oz) of water.

• Tell patient not to lie down, eat, drink, or take other oral medications for 30 minutes after taking dose.

• Advise patient to take only those pain relievers suggested by prescriber. Inform him that some over-the-counter pain medications (such as aspirin and NSAIDs) may worsen drug's adverse effects.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and foods mentioned above.

McGraw-Hill Nurse's Drug Handbook, 7th Ed. Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved


A trademark for the drug alendronate sodium.
The American Heritage® Medical Dictionary Copyright © 2007, 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved.


A biphosphonate used to treat postmenopausal osteoporosis and Paget’s disease of bone. Alendronate reduces vertebral fractures by 48% and other fractures by 21%, increases bone density by 9% and density of the hip bones by 6% over 3 years of therapy.

Adverse effects
Nausea, stomach pain, constipation, diarrhoea, bloating, headaches, dizziness, swelling of joints (especially of hands and feet).

Mechanism of action
Marked inhibition of bone resorption by inhibiting osteoclastic activity and number of osteoclasts by reducing recruitment, and increasing apoptosis.
Segen's Medical Dictionary. © 2012 Farlex, Inc. All rights reserved.


Alendronate, see there.
McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.


A brand name for ALENDRONATE.
Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005
References in periodicals archive ?
Although the ADA says that the risk of getting BON from Fosamax is low, dentists have noticed an increase in cases since 2003.
Although the initial study showed significantly less osteoporotic fracture incidence in the treatment group (10.6%) compared with the placebo group (21.0%), the extension trial did not: continuous Fosamax treatment had a fracture incidence of 17.7% compared with 16.9% for those who were switched to placebo.
We remain confident in the efficacy and safety profile of Fosamax, which was developed and studied carefully by dedicated Merck scientists."
Having a hip fracture as a result of medication can happen at an inordinately young age in people whose doctors prescribed Fosamax," states NY defective prescription drug attorney, Rudy Migliore.
Merck (the manufacturer of Fosamax) tried to hide the fact that Fosamax is causing jawbone death!
Plaintiffs in the other Fosamax cases make similar assertions, claiming the drug causes death of the jaw bone, also known as osteonerosis.
The manufacturers of alendronate (Fosamax and Fosamax plus D, by Merck & Co.), ibandronate (Boniva, by Roche Laboratories), risedronate (Actonel and Actonel with calcium, by Procter & Gamble Pharmaceuticals), and zoledronic acid (Reclast and Zometa, by Novartis) included data from men and women treated with each of those drugs.
Women who take Fosamax to reduce their future risk of osteoporosis be warned: you are at increased risk for atrial fibrillation, a heart condition that increases strokes.
Our options seem to be Liquid Fosamax (for G-tube) or the new once a year IV drug Reclast.
For example, Alendronate, a generic version of Fosamax, an osteoporosis medication, is now available from Wal-Mart, Sam's Club and Neighborhood Market outlets for $9 for a 30-day supply or $24 for a 90-day supply.
Thousands of British women take Fosamax for the bone-thinning disease which is a common side effect of the menopause.
from Sandusky, Ohio: Generic verions of Altace, Fosamax, Zetia, and Avandia are not currently available.