Alendronate-Fosamax

Why is this medication prescribed?
Alendronate is used to treat and prevent osteoporosis (a condition in which the bones become thin and weak and break easily) in women who have undergone menopause (change of life; end of menstrual periods). Alendronate is also used to treat osteoporosis in men and women, who are taking corticosteroids (a type of medication that may cause osteoporosis in some patients). Alendronate is also used to treat Paget's disease of bone (a condition in which the bones are soft and weak and may be deformed, painful, or easily broken). Alendronate is in a class of medications called bisphosphonates. It works by preventing bone breakdown and increasing bone density (thickness).

What is the most important information I should know about alendronate?
• Do not take an alendronate 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.
• Take the alendronate tablet first thing in the morning, at least 30 minutes before you eat or drink anything or take any other medicine.
• Take each dose with a full glass (6 to 8 ounces) of water. Use only plain water (not mineral water) when taking an alendronate tablet.
• For at least the first 30 minutes after taking an alendronate tablet, do not lie down or recline; do not eat or drink anything other than plain water; and do not take any other medicines including vitamins, calcium, or antacids.
• Some people using medicines similar to alendronate have developed bone loss in the jaw, also called osteonecrosis of the jaw. Symptoms of this condition may include jaw pain, swelling, numbness, loose teeth, gum infection, or slow healing after injury or surgery involving the gums. You may be more likely to develop osteonecrosis of the jaw if you have cancer or have been treated with chemotherapy, radiation, or steroids. Other conditions associated with osteonecrosis of the jaw include blood clotting disorders, anemia (low red blood cells), and a pre-existing dental problem.
• Alendronate 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.

How should you use medication?
Alendronate 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 Alendronate 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 Alendronate 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 Alendronate 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 drug(s) may interact with alendronate?
•aluminum hydroxide
•antacids
•anti-inflammatory drugs like ibuprofen, naproxen, and others
•aspirin
•calcium supplements
•iron supplements
•magnesium supplements
•parathyroid hormone
•teriparatide
•vitamins with minerals

Tell your prescriber or health care professional about all other medicines you are taking including non-prescription medicines. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These can affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What side effects might I notice from taking alendronate?
Side effects that you should report to your prescriber or health care professional as soon as possible:
More common:
•stomach pain
•heartburn
•pain or difficulty swallowing
Rare or uncommon:
•allergic reactions such as skin rash or itching, hives, swelling of the face, lips, throat or tongue
•black or tarry stools
•constant jaw pain, especially burning or cramping
•eye inflammation, pain or change in vision
•muscle twitching
•redness, blistering, peeling or loosening of the skin, including inside the mouth
•vomiting

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):
•diarrhea or constipation
•headache
•stomach gas or fullness
•nausea
•changes in taste
•bone, muscle or joint pain
•rash, which may be made worse by prolonged exposure to sunlight