Fosamax contains the active ingredient alendronate sodium, which is a bisphosphonate that inhibits bone resorption by osteoclasts. It comes in tablet form for oral administration in dosages equivalent to 10 mg, 35 mg, and 70 mg of free acid. The tablets also include inactive ingredients such as corn starch, magnesium stearate, microcrystalline cellulose, povidone, and sodium starch glycolate. Fosamax is specifically designed to bind to bone, reflecting its role in bone health management.

How should I use this medication?

Take this medication by mouth with a full glass of water. Take it as directed on the prescription label at the same time every day. Use a specially marked oral syringe, spoon, or dropper to measure each dose. Ask your pharmacist if you do not have one. Household spoons are not accurate. Take the dose right after waking up. Do not eat or drink anything before taking it. Do not take it with any other drink except water. After taking it, do not eat breakfast, drink, or take any other medications or vitamins for at least 30 minutes. Sit or stand up for at least 30 minutes after you take it. Do not lie down. Keep taking it unless your care team tells you to stop.

A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

Talk to your care team about the use of this medication in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you take your medication once a day, skip it. Take your next dose at the scheduled time the next morning. Do not take two doses on the same day.

If you take your medication once a week, take the missed dose on the morning after you remember. Do not take two doses on the same day.

Where should I keep my medication?

Keep out of the reach of children and pets.

Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F). Do not freeze. Throw away any unused medication after the expiration date.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

• Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
• Low calcium level—muscle pain or cramps, confusion, tingling, or numbness in the hands or feet
• Osteonecrosis of the jaw—pain, swelling, or redness in the mouth, numbness of the jaw, poor healing after dental work, unusual discharge from the mouth, visible bones in the mouth
• Pain or trouble swallowing
• Severe bone, joint, or muscle pain
• Stomach bleeding—bloody or black, tar-like stools, vomiting blood or brown material that looks like coffee grounds

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

• Constipation
• Diarrhea
• Nausea
• Stomach pain

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

• Bleeding disorder
• Cancer
• Dental disease
• Difficulty swallowing
• Infection (fever, chills, cough, sore throat, pain or trouble passing urine)
• Kidney disease
• Low levels of calcium or other minerals in the blood
• Low red blood cell counts
• Receiving steroids like dexamethasone or prednisone
• Stomach or intestine problems
• Trouble sitting or standing for 30 minutes
• An unusual or allergic reaction to alendronate, other medications, foods, dyes or preservatives
• Pregnant or trying to get pregnant
• Breast-feeding

What may interact with this medication?

• Aluminum hydroxide
• Antacids
• Aspirin
• Calcium supplements
• Iron supplements
• Magnesium supplements
• Medications for inflammation like ibuprofen, naproxen, and others
• Vitamins with minerals

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Visit your care team for regular checks on your progress. It may be some time before you see the benefit from this medication.

Some people who take this medication have severe bone, joint, or muscle pain. This medication may also increase your risk for jaw problems or a broken thigh bone. Tell your care team right away if you have severe pain in your jaw, bones, joints, or muscles. Tell you care team if you have any pain that does not go away or that gets worse.

Tell your dentist and dental surgeon that you are taking this medication. You should not have major dental surgery while on this medication. See your dentist to have a dental exam and fix any dental problems before starting this medication. Take good care of your teeth while on this medication. Make sure you see your dentist for regular follow-up appointments.

You should make sure you get enough calcium and vitamin D while you are taking this medication. Discuss the foods you eat and the vitamins you take with your care team.

You may need blood work done while you are taking this medication.