Alendronate (Fosamax | Fosavance)
Fosamax or Fosavance (alendronic acid or alendronic sodium) is a bisphosphonate medicine used to prevent and treat thinning of the bones (called osteoporosis), a condition called Paget’s disesase, and other diseases where loss of bone mass is a concern.
Bisphosphonates are a class of medicines that all work in a similar way to help the bones.
Taking Fosamax | Fosavance
Fosamax is available in oral tablet form in a variety of different dosages. 5 mg or 10 mg tablets are taken once a day. 35 mg or 70 mg tablets are taken once a week.
To minimize side-effects and ensure the best response, we recommend that patients take Fosamax as follows:
Fosamax should be taken first thing in the morning. Patients should not lie down after taking this medicine.
Fosamax should be taken on an empty stomach. Patients should wait at least 1 hour before taking any other medication, or eating or drinking anything other than clean water (no coffee, juice, or tea).
It is recommended that patients drink a full glass of water while taking their tablet.
To help build the bones, patients should take calcium and vitamin D supplements while taking Fosamax. A doctor can tell you the right amount of calcium and vitamin D to take.
Important Tests and Risks
Doctors need to monitor the response of patients taking Fosamax. This is done with a Bone Mineral Density test, usually once every 1 to 3 years.
Bisphosphonate medicines like Fosamax have been associated with a very rare problem with the jaw called osteonecrosis. This problem is sometimes seen after dental work.
People taking Fosamax should let their doctor know if they develop sudden pain in the jaw.
Alcohol is known to increase fracture risk by decreasing bone mineral density and promoting osteoporosis.
Patients who are prescribed Fosamax should stop drinking alcohol, or at least reduce the amount of alcohol that they drink.
Science
The body features an ongoing process called bone remodeling where bones are constantly broken down (called bone resorption) and build back up.
Bones are broken down by a type of cell called osteoclasts and are built back up by a type of cell called osteoblasts.
In people with osteoporosis and Paget’s disease, too much bone is being broken down too quickly.
All bisphosphonate medications, including Fosamax, bind to the surface of bones and slow down the bone resorption process. It works because it is toxic to the osteoclasts that break down bone.
When Fosamax slows down the bone resorption process, it gives the body more time to build up and strengthen the bones.
Safety
Patients should talk to their doctor if they are concerned about any side effects.
The most common side effect of Fosamax is stomach upset, pain, bloating, and nausea. To minimize side effects, it is best to take Fosamax as prescribed: in the morning before any food or drink other than water. It is best to wait at least one hour after taking Fosamax before taking any other medication or eating or drinking anything else but water.
- Nausea & diarrhea – The most common side effect of Didrocal is stomach upset, pain, bloating, and nausea. Didrocal can irritate the lining of the stomach, esophagus, or intestine. This is rare. It can result in stomach pain or trouble swallowing.
- Headache – Didrocal can rarely cause a headache.
- Muscle & bone pain – Didrocal can rarely cause bone, muscle, or joint pain.
Fosamax should not be taken during pregnancy or breastfeeding. Patients who become pregnant should stop taking the medicine and contact their doctor.
People who should NOT be taking Fosamax include:
- Patients who are allergic to Fosamax or any ingredient in this medicine
- Patients who are allergic to other bisphosphonate medications
- Patients that are pregnant or breast-feeding
Anyone who becomes pregnant while taking Fosamax should notify their doctor immediately.
People taking Fosamax should call their doctor if they feel sick and want to stop, or they are concerned about any side effects.
Other reasons to call a doctor while taking Fosamax include:
- Stomach pain or trouble swallowing
- Pregnant or Planning Pregnancy
- New severe pain in the jaw
- Upcoming surgery
Video
Watch Dr. Andy Thompson, a Canadian rheumatologist, introduce Fosamax in this short video: