Fosamax (alendronate) is in the group of medicines called bisphosphonates (bis FOS fo nayts). It alters the cycle of bone formation and breakdown in the body. Fosamax slows bone loss while increasing bone mass, which may prevent bone fractures.
Fosamax is used in men and women to treat or prevent osteoporosis that is caused by menopause or by taking steroids. Fosamax is also used to increase bone mass in men who have osteoporosis, and to treat Paget's disease of bone in men and women.
Fosamax may also be used for other purposes not listed in this medication guide.
Important information about Fosamax
Do not take a Fosamax tablet if you cannot sit upright or stand for at least 30 minutes. Fosamax 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 Fosamax.
Take the Fosamax 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, coffee, tea, or juice) when taking a Fosamax tablet.
For at least the first 30 minutes after taking a Fosamax 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 Fosamax have developed bone loss in the jaw, also called osteonecrosis of the jaw. Symptoms 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.
If you need to have any dental work (especially surgery), tell the dentist ahead of time that you are using Fosamax. You may need to stop using the medicine for a short time.
Fosamax 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.
Before taking Fosamax
Do not take a Fosamax tablet if you cannot sit upright or stand for at least 30 minutes. Fosamax 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.
You should not take Fosamax if you are allergic to alendronate, or if you have low levels of calcium in your blood (hypocalcemia), or a problem with the movement of muscles in your esophagus.
To make sure you can safely take Fosamax, tell your doctor if you have any of these other conditions:
- trouble swallowing;
- a vitamin D deficiency;
- a dental problem;
- kidney disease; or
- an ulcer or other problem in your stomach or esophagus.
Some people using medicines similar to Fosamax have developed bone loss in the jaw, also called osteonecrosis of the jaw. Symptoms 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 dental surgery or pre-existing dental problems.
FDA pregnancy category C. It is not known whether Fosamax will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. It is not known whether alendronate passes into breast milk or if it could harm a nursing baby. Do not use Fosamax without telling your doctor if you are breast-feeding a baby.
How should I take Fosamax?
Take Fosamax exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.
Fosamax tablets are taken either once each day or once each week.
Take the Fosamax tablet first thing in the morning, at least 30 minutes before you eat or drink anything or take any other medicine. If you take a Fosamax tablet only once a week, take it on the same day each week and always first thing in the morning.
Take each Fosamax tablet with a full glass (6 to 8 ounces) of water. Use only plain water (not mineral water) when taking a tablet. Do not crush, chew, or suck the Fosamax tablet. Swallow the pill whole.
After taking a Fosamax tablet, carefully follow these instructions:
- Do not lie down or recline for at least 30 minutes after taking Fosamax.
- Do not eat or drink anything other than plain water.
- Do not take any other medicines including vitamins, calcium, or antacids for at least 30 minutes after taking Fosamax. It may be best to take your other medicines at a different time of the day. Talk with your doctor about the best dosing schedule for your other medicines.
To be sure Fosamax is helping your condition, your bone mineral density will need to be tested on a regular basis. Visit your doctor regularly.
If you need to have any dental work (especially surgery), tell the dentist ahead of time that you are using this medicine. You may need to stop using the medicine for a short time.
Fosamax 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.
Store at room temperature away from moisture and heat.
What happens if I miss a dose?
If you take Fosamax tablets once daily: If you forget to take this medicine first thing in the morning, do not take it later in the day. Wait until the following morning to take the medicine and skip the missed dose. Do not take two (2) tablets in one day.
If you take Fosamax tablets once a week: If you forget to take Fosamax on your scheduled day, take it first thing in the morning on the day after you remember the missed dose. Then return to your regular weekly schedule on your chosen dose day. Do not take two (2) tablets in one day.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Drink a full glass of milk and call your local poison control center or emergency room right away. Do not make yourself vomit and do not lie down.
Overdose symptoms may include nausea, heartburn, stomach pain, diarrhea, muscle cramps, numbness or tingling, tight muscles in your face, seizure (convulsions), irritability, and unusual thoughts or behavior.
What should I avoid while taking Fosamax?
Avoid taking any other medicines including vitamins, calcium, or antacids for at least 30 minutes after taking a Fosamax tablet. Some medicines can make it harder for your body to absorb Fosamax. Do not lie down for at least 30 minutes after you take a tablet.
Fosamax side effects
Get emergency medical help if you have any of these signs of an allergic reaction to Fosamax: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using Fosamax and call your doctor at once if you have any of these serious side effects:
- chest pain;
- difficulty or pain when swallowing;
- pain or burning under the ribs or in the back;
- severe heartburn, burning pain in your upper stomach, or coughing up blood;
- new or worsening heartburn;
- fever, body aches, flu symptoms;
- severe joint, bone, or muscle pain;
- new or unusual pain in your thigh or hip;
- jaw pain, numbness, or swelling.
Less serious Fosamax side effects may include:
- mild heartburn, bloating;
- mild nausea, vomiting, or stomach pain;
- diarrhea, gas, or constipation;
- mild joint pain or swelling;
- swelling in your hands or feet; or
- dizziness, eye pain, headache.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What other drugs will affect Fosamax?
Tell your doctor about all other medicines you use, especially aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as:
- celecoxib (Celebrex);
- diclofenac (Voltaren);
- diflunisal (Dolobid);
- ibuprofen (Motrin, Advil);
- indomethacin (Indocin);
- ketoprofen (Orudis)
- ketorolac (Toradol);
- naproxen (Aleve, Naprosyn); or
- piroxicam (Feldene), and others.
This list is not complete and other drugs may interact with Fosamax. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.
