Alendronate: uses, dosing, side effects & brands
Alendronate is a bisphosphonate sold in the U.S. under 3 brand and generic names, for extramammary paget disease and postmenopausal osteoporosis. Below: what the FDA label says, every product that contains it, what the pills look like, and its recall record.
Key facts
- Drug class
- Bisphosphonate
- Treats (across its forms)
- Extramammary Paget Disease and Postmenopausal Osteoporosis
- Available as
- Solution · Tablet · Tablet, effervescent
- Sold as
- 3 products — Alendronate Sodium, Fosamax and Binosto
- Prescription?
- Prescription only
- Generic available?
- Yes
- What the pharmacy pays
- about $8 for a 30-count supply — not your price
How Fosamax is dosed
From the FDA label for Fosamax (application NDA021575). Other alendronate products — different forms, different strengths — are dosed differently. Follow the label for the one you were prescribed.
Although alendronate tablets 5 mg, 10 mg, 35 mg, and 40 mg are available in the marketplace, FOSAMAX is no longer marketed in the 5 mg, 10 mg, 35 mg, and 40 mg strengths. Although an oral solution of alendronate may be available in the marketplace, FOSAMAX oral solution is no longer marketed. Treatment of osteoporosis in postmenopausal women and in men: 10 mg daily or 70 mg (tablet or oral solution) once weekly. ( 2.1 , 2.3 ) Prevention of osteoporosis in postmenopausal women: 5 mg daily or 35 mg once weekly. ( 2.2 ) Glucocorticoid-induced osteoporosis: 5 mg daily; or 10 mg daily in postmenopausal women not receiving estrogen. ( 2.4 ) Paget's disease: 40 mg daily for six months. ( 2.5 ) Instruct patients to: ( 2.6 ) Swallow tablets whole with 6-8 ounces plain water at least 30 minutes before the first food, drink, or medication of the day. Swallow oral solution followed by at least 2 ounces of water. Not lie down for at least 30 minutes after taking FOSAMAX and until after food. 2.1 Treatment of Osteoporosis in Postmenopausal Women The recommended dosage is: one 70 mg tablet once weekly or one bottle of 70 mg oral solution once weekly or one 10 mg tablet once daily 2.2 Prevention of Osteoporosis in Postmenopausal Women The recommended dosage is: one 35 mg tablet once weekly or one 5 mg tablet once daily 2.3 Treatment to Increase Bone Mass in Men with Osteoporosis The…
Everything below is the FDA label for Fosamax (tablet). Alendronate is also sold as solution and tablet, effervescent, and those are different medicines to take — follow the label for the one you were prescribed.
Fosamax side effects
The following clinically significant adverse drug reactions are described elsewhere in the labeling: Upper Gastrointestinal Adverse Reactions [see Warnings and Precautions (5.1) ] Mineral Metabolism [see Warnings and Precautions (5.2) ] Musculoskeletal Pain [see Warnings and Precautions (5.3) ] Osteonecrosis of the Jaw [see Warnings and Precautions (5.4) ] Atypical Fractures Including Femoral Fractures [see Warnings and Precautions (5.5) ] Renal Impairment [see Warnings and Precautions (5.6) ] Glucocorticoid-Induced Osteoporosis [see Warnings and Precautions (5.7) ] Most common adverse reactions (greater than or equal to 3%) are abdominal pain, acid regurgitation, constipation, diarrhea, dyspepsia, musculoskeletal pain, nausea. ( 6.1 ) To report SUSPECTED ADVERSE REACTIONS, contact Organon LLC, a subsidiary of Organon & Co., at 1-844-674-3200 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. 6.1 Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in clinical practice. Treatment of Osteoporosis in Postmenopausal Women Daily Dosing The safety of FOSAMAX in the treatment of postmenopausal osteoporosis was assessed in four clinical trials that enrolled 7453…
Who shouldn’t take Fosamax
FOSAMAX is contraindicated in patients with the following conditions: Abnormalities of the esophagus which delay esophageal emptying such as stricture or achalasia [see Warnings and Precautions (5.1) ] Inability to stand or sit upright for at least 30 minutes [see Dosage and Administration (2.6) ; Warnings and Precautions (5.1) ] Do not administer FOSAMAX oral solution to patients at increased risk of aspiration. Hypocalcemia [see Warnings and Precautions (5.2) ] Hypersensitivity to any component of this product. Hypersensitivity reactions including urticaria and angioedema have been reported [see Adverse Reactions (6.2) ] . Abnormalities of the esophagus which delay emptying such as stricture or achalasia ( 4 , 5.1 ) Inability to stand/sit upright for at least 30 minutes ( 2.6 , 4 , 5.1 ) Do not administer FOSAMAX oral solution to patients at increased risk of aspiration ( 4 ) Hypocalcemia ( 4 , 5.2 ) Hypersensitivity to any component of this product ( 4 , 6.2 )
Fosamax drug interactions
Calcium supplements, antacids, or oral medications containing multivalent cations interfere with absorption of alendronate. ( 2.6 , 7.1 ) Use caution when co-prescribing aspirin/nonsteroidal anti-inflammatory drugs that may worsen gastrointestinal irritation. ( 7.2 , 7.3 ) 7.1 Calcium Supplements/Antacids Co-administration of FOSAMAX and calcium, antacids, or oral medications containing multivalent cations will interfere with absorption of FOSAMAX. Therefore, instruct patients to wait at least one-half hour after taking FOSAMAX before taking any other oral medications. 7.2 Aspirin In clinical studies, the incidence of upper gastrointestinal adverse events was increased in patients receiving concomitant therapy with daily doses of FOSAMAX greater than 10 mg and aspirin-containing products. 7.3 Nonsteroidal Anti-Inflammatory Drugs FOSAMAX may be administered to patients taking nonsteroidal anti-inflammatory drugs (NSAIDs). In a 3-year, controlled, clinical study (n=2027) during which a majority of patients received concomitant NSAIDs, the incidence of upper gastrointestinal adverse events was similar in patients taking FOSAMAX 5 or 10 mg/day compared to those taking placebo. However, since NSAID use is associated with gastrointestinal irritation, caution should be used during concomitant use with FOSAMAX.
Every alendronate product we track (3)
Same active ingredient — different manufacturer, form, price and FDA recall record. That last one is what our independent score measures.
| # | Drug | Rating | Type | Form | Generic? | Pharmacy pays | |
|---|---|---|---|---|---|---|---|
| 1 | 70/100 | Prescription | Solution | Generic | $8 | View → | |
| 2 | 70/100 | Prescription | Tablet | Generic | $8 | View → | |
| 3 | Not yet rated | Prescription | Tablet | Generic | $8 | View → |
What alendronate pills look like
Imprint codes, colour and shape from the FDA’s labelling data. Match the imprint on your pill — or search any imprint.
Combination products containing alendronate
A combination is a different drug — different dosing, different warnings. It is listed here so you can find it, not so you can substitute it.
Alendronate recalls
From the FDA Enforcement database. A recall covers specific lots — not the drug as a whole.
How long alendronate keeps
No alendronate label we read sets a separate limit for after opening, but they do specify how it must be stored — and the stability behind any date assumes those conditions.
Does alendronate expire? The in-use limits and storage rules from its labelsAlendronate and breastfeeding
From LactMed, the US National Library of Medicine’s Drugs and Lactation Database — quoted, not rewritten.
Full LactMed record for alendronate: levels in milk, effects in breastfed infants, and the drugs it would consider insteadLimited evidence indicates that breastfeeding after cessation of long-term bisphosphonate treatment appears to have no adverse effects on the infant. Because no information is available on the use of alendronate during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant. However, absorption of alendronate by a breastfed infant is unlikely. If the mother receives a bisphosphonate during pregnancy or nursing, some experts recommend monitoring the infant's serum calcium during the first 2 months postpartum.
National Institute of Child Health and Human Development, record revised December 3, 2018. LactMed states its information is not a substitute for professional judgement.
What people report to the FDA about alendronate
The FDA Adverse Event Reporting System (FAERS) collects reports from patients and clinicians. It holds 35,450 reports naming alendronate, and the FDA flagged 82% of those reports as serious. The effects reported most often — leaving out reports about overdose, misuse or the condition being treated, which dominate the raw list for common medicines:
- fatigue6,257 reports
- arthralgia5,765 reports
- rheumatoid arthritis5,320 reports
- femur fracture5,071 reports
- abdominal discomfort5,015 reports
- rash4,973 reports
- alopecia4,950 reports
- arthropathy4,648 reports
Read these as a signal, not a rate. A report does not mean alendronate caused the effect — anyone can file one, and many describe people taking several medicines for several conditions. Crucially there is no denominator: FAERS does not record how many people took the drug, so these counts cannot be turned into “X% of patients” — a bigger number often just means a more widely used or more talked-about drug. Duplicates exist, and publicity drives reporting. For what is actually established, read the FDA label section above.
Source: openFDA drug/event (FAERS), retrieved July 25, 2026.
Related guides
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Frequently asked questions
What is Fosamax?
FOSAMAX (alendronate sodium) is a bisphosphonate that acts as a specific inhibitor of osteoclast-mediated bone resorption. Bisphosphonates are synthetic analogs of pyrophosphate that bind to the hydroxyapatite found in bone.
What kind of drug is alendronate?
The FDA classifies alendronate as a bisphosphonate. Bisphosphonates stick to the mineral surface of bone, especially where it is being broken down. When the bone-dissolving cells (osteoclasts) take the drug up, it disables or kills them, slowing bone loss and helping keep bones denser and stronger. If you are checking whether it is safe to combine with something else, the class is what matters — two drugs from the same class usually should not be stacked.
Can you take alendronate with other medicines?
It depends on the medicine. We check it against the FDA labels rather than guessing: our interaction checker searches each drug's own label for the other and quotes what it says, naming the section it came from. Run alendronate against whatever else you take — and remember that a label not naming a drug is not the same as that combination being safe.
What brand names is alendronate sold under?
We track 3 alendronate-containing products in the U.S.: Alendronate Sodium, Fosamax and Binosto. They are the same active ingredient; they differ in form, manufacturer, price and FDA recall record.
What forms does alendronate come in?
Across the brands we track, alendronate is currently marketed as solution, tablet and tablet, effervescent, per the FDA's National Drug Code Directory. Each form is dosed differently — follow the label for the exact product you were prescribed.
Is there a generic alendronate?
Yes. Our catalog lists 1 generic alendronate product alongside the brand versions. A generic has the same active ingredient and must meet the FDA's bioequivalence standard; it usually costs less. Ask your pharmacist which one your plan covers.
Has alendronate been recalled?
The FDA's Enforcement database lists 1 recall record whose product description mentions alendronate. The most recent: Alendronate Sodium Oral Solution (Apr 7, 2026). A recall applies to specific lots, not to the drug as a whole — check the record for the affected lot numbers.
Cite this page
- APA
- pharmaranks. (2026, July 24). Alendronate: uses, dosing, side effects & brands. https://pharmaranks.com/drugs/alendronate
- MLA
- “Alendronate: uses, dosing, side effects & brands.” pharmaranks, 24 July 2026, https://pharmaranks.com/drugs/alendronate.
We summarise public FDA and NIH sources — for a clinical claim, cite the primary source we link to as well.
Sources: FDA openFDA drug label, National Drug Code Directory, and Enforcement (recall) database. This page reproduces public FDA data and is not medical advice. Dosing is set by your prescriber.
Read the full FDA label for alendronate on DailyMed (NIH) ↗.