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Brand Name: Fosamax, Binosto, Fosamax Plus D

Generic Name: Alendronate

Drug Class: Calcium Metabolism Modifiers; Bisphosphonate Derivatives

What Is Alendronate and How Does It Work?

Alendronate is used to prevent and treat certain types of bone loss (osteoporosis) in adults. Osteoporosis causes bones to become thinner and break more easily. Your chance of developing osteoporosis increases as you age, after menopause, or if you are taking corticosteroid medications (such as prednisone) for a long time.

Alendronate works by slowing bone loss. This effect helps maintain strong bones and reduce the risk of broken bones (fractures). Alendronate belongs to a class of drugs called bisphosphonates.

Alendronate is available under the following different brand names: Fosamax, Binosto, and Fosamax Plus D.

Dosages of Alendronate:

Dosage Forms and Strengths


  • 5 mg
  • 10 mg
  • 35 mg
  • 40 mg
  • 70 mg

Tablet for solution (effervescent)

  • 70 mg

Solution, oral

  • 70 mg/75mL

Dosage Considerations – Should be Given as Follows:


Prevention in postmenopausal women

  • 5 mg orally once daily or 35 mg orally once weekly

Treatment in postmenopausal women and men

  • 10 mg orally once daily or 70 mg orally once weekly

Glucocorticoid-Induced Osteoporosis

  • Males and females: 5 mg orally once daily (10 mg/day for postmenopausal women not on hormone replacement therapy)

Paget Disease

  • 40 mg/day orally for 6 months

Dosing Modifications

  • Mild-to-moderate renal impairment (CrCl 35-60 mL/min): Dose adjustment not necessary
  • Severe renal impairment (CrCl less than 35 mL/min): Not recommended


  • Take only in morning, not at bedtime or before arising
  • Take tablet with full glass of water (6-8 oz) at least 30 minutes before first food or drink of day, in upright position
  • Administer oral solution with at least 2 ounces of water
  • Swallow with plain water only; mineral water, coffee, juice or other beverages severely reduces bioavailability
  • Swallow tablet whole; do not suck or chew
  • Do not lie down for 30 minutes after taking drug; sit or stand upright
  • Despite long terminal half-life (10 years), bone-incorporated drug is not pharmacologically active
  • If dietary intake is inadequate, patients should receive calcium supplement and vitamin D

Limitation of Use

  • Optimal duration of use not determined; for patients at low-risk for fracture, consider drug discontinuation after 3-5 years of use
  • Pediatric: Safety and efficacy not established
Medically Reviewed by a Doctor on 8/10/2017

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