Known brand names include Fosamax, Binosto, and Fosamax Plus D.
A bisphosphonate pill that slows bone breakdown to treat and prevent osteoporosis and treat Paget's disease of bone. It must be taken first thing in the morning with a full glass of plain water, at least 30 minutes before food, drink, or other medicines, while staying upright, to protect the esophagus.
Bone is constantly broken down by cells called osteoclasts and rebuilt by other cells. Alendronate binds to bone mineral and gathers where bone is being broken down, right under the osteoclasts. There it stops the osteoclasts from working, though they still reach and attach to the bone. Fewer spots of bone are remodeled at any time, and at those spots more bone is laid down than removed, so bone mass slowly builds.
Lab signs of slower bone breakdown show up within about a month, but bone density may take 3 months or longer to start rising. Once covered by new bone it stops acting, so it has to be taken steadily to reach new sites of breakdown. Very little of each dose is absorbed, and food, coffee, or juice cut that even more, which is why it is taken with plain water on an empty stomach. It can irritate the lining of the esophagus, the tube from the mouth to the stomach, and lying down after a dose or not drinking enough water raises the risk of serious sores there.
Alendronate treats osteoporosis, a condition in which bones thin out, weaken, and break easily, in women after menopause. In these women it builds bone and lowers the risk of fractures, including those of the hip and spine. It also helps prevent osteoporosis after menopause and builds bone in men who have osteoporosis.
It also treats bone loss in men and women who take steroid medicines such as prednisone every day and have low bone density. It treats Paget's disease of bone, in which bones become soft and weak and may be misshapen, painful, or easy to break. The tablets are taken by mouth first thing in the morning on an empty stomach. The best length of treatment is not known, and people at low fracture risk may stop after 3 to 5 years.
Stomach pain, heartburn, acid reflux, nausea, constipation, diarrhea, and bone, muscle, or joint pain are the common complaints. The label treats irritation, ulcers, and bleeding of the esophagus as the main danger, especially if someone lies down after a dose or does not take it with enough water. It also warns about low calcium, severe bone or joint pain, jaw bone damage after dental work, and unusual thigh bone fractures that often start with dull thigh or groin pain.