How do I take alendronate (bisphosphonate)?

How to Take Alendronate (Bisphosphonate) Properly

Alendronate must be taken on an empty stomach with a full glass of plain water (6-8 oz), while sitting or standing upright, and you must remain upright for at least 30 minutes after taking it to prevent esophageal irritation. 1

Proper Administration Instructions

• Take alendronate exactly as prescribed - either daily (10 mg) or weekly (70 mg) dosing, with the weekly regimen being more convenient and equally effective 2
• Take alendronate first thing in the morning after getting up and before consuming any food, beverages, or other medications 1
• Swallow the tablet whole with 6-8 ounces (full glass) of plain water only - not mineral water, coffee, tea, juice, or other beverages 1
• Do not chew, crush, or suck on the tablet 1
• Remain in an upright position (sitting or standing) for at least 30 minutes after taking alendronate 1, 3
• Wait at least 30 minutes after taking alendronate before:
  • Lying down 1
  • Consuming your first food or drink of the day 1
  • Taking other medications, including calcium supplements 1, 3

Dosing Schedule

• If taking daily alendronate: Take one tablet (10 mg) every day 1
• If taking weekly alendronate: Take one tablet (70 mg) on the same chosen day each week 1, 2
• If you miss a dose:
  • Do not take the missed dose later in the day
  • Take your next dose on the following morning as scheduled
  • Never take two doses on the same day 1

Important Precautions

• Alendronate should not be taken by individuals who:
  • Have certain esophageal problems
  • Cannot remain upright for at least 30 minutes
  • Have low blood calcium levels
  • Are allergic to alendronate or its ingredients 1
• Bisphosphonates should be taken at a different time than calcium supplements as calcium binds and inactivates bisphosphonates 3
• Oral alendronate should be avoided in patients with cirrhosis who may have esophageal varices due to the risk of precipitating variceal hemorrhage 3
• Vitamin D deficiency should be corrected prior to starting bisphosphonate therapy to maximize effectiveness and reduce the risk of hypocalcemia 3

Common Side Effects

• Gastrointestinal issues are the most common side effects, including:
  • Abdominal pain
  • Heartburn
  • Constipation
  • Diarrhea
  • Nausea 1
• Proper administration technique (as described above) significantly reduces the risk of esophageal irritation 1, 4

Special Considerations

• For patients with swallowing difficulties, alternative formulations may be available in some countries, such as oral jelly formulations 5
• The weekly dosing regimen (70 mg once weekly) provides similar efficacy to daily dosing while improving convenience and potentially reducing the risk of upper gastrointestinal side effects 2, 6
• Alendronate should be taken consistently as prescribed for the duration recommended by your healthcare provider, typically 3-5 years 3

By following these specific instructions carefully, you can maximize the effectiveness of alendronate while minimizing potential side effects.