Alendronate
Brand: Fosamax
No boxed warning on the current FDA label.
- Caution
- Esophageal irritation and ulcers: contraindicated if the patient cannot stay upright for 30 minutes or has esophageal abnormalities; rare jaw osteonecrosis and atypical femur fractures.
Common side effects
- Heartburn
- Esophagus irritation
- Stomach upset
- Muscle or joint pain
- Difficulty swallowing
Key interactions
- Calcium, antacids, and iron reduce absorption
- Separate from other medicines and food
- NSAIDs may add to stomach irritation
Counseling points
- Take on empty stomach with plain water
- Stay upright at least 30 minutes after
- Take before first food or drink of day
- Report trouble swallowing or chest pain
- Ensure adequate calcium and vitamin D
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