Fosamax
® (
alendronate sodium) is a prescription medication approved for the following uses:
- Treating osteoporosis in both men in women due to steroid medications, such as prednisone
- Preventing and treating osteoporosis in postmenopausal women
- Treating osteoporosis in men
- Treating Paget's disease in men and women.
Fosamax is made by Merck & Co., Inc.
Fosamax belongs to a group of medications known as bisphosphonates. The drug binds to certain cells in bones and slows down the rate at which they break down.
Fosamax has been evaluated in several studies for various osteoporosis-related uses.
Fosamax and Postmenopausal Women
Fosamax has been evaluated in four studies of postmenopausal women with osteoporosis. In these studies, the drug reduced the risk of vertebral fractures (broken spinal bones) by 48 percent. In women who already had a vertebral fracture before starting it, the drug reduced the risk of a broken hip or wrist by about 50 percent. The studies also showed that the medication increased the bone mineral density (a measure of the strength of bones) in the spine and hip. Interestingly, women taking it lost less height, compared with women not taking it.
It can also be used to prevent osteoporosis in postmenopausal women with risk factors for the disease. In studies, women taking the drug showed increased bone mineral density, while those not taking it actually experienced bone loss.
Fosamax and Men
Studies have shown that the drug can help increase bone mineral density in men with
osteoporosis and can help prevent loss of height due to the disease. Studies have not shown that the drug prevents broken bones in men. However, this is most likely due to the small number of men in Fosamax studies (since studies need many people in order to show any changes in the frequency of broken bones).
Fosamax and Steroids
Osteoporosis is one of the side effects of long-term use of steroids, such as
prednisone. Studies have shown that Fosamax can treat osteoporosis in people who take steroids. In these studies, people taking the drug had increased bone mineral density, compared to people not taking it.
Fosamax and Paget's Disease
One way to assess the severity of Paget's disease is by measuring the level of alkaline phosphate in the blood. In studies, Fosamax was shown to decrease alkaline phosphate levels, which indicates that it helps to improve Paget's disease. Studies compared Fosamax with
Didronel® (
etidronate), a similar medication used to treat Paget's disease. Up to 85 percent of people taking Fosamax achieved normal alkaline phosphate levels or significantly reduced levels, compared to just 30 percent of those taking Didronel.
When and How to Take Fosamax
General considerations for when and how to take Fosamax include the following:
- The medication comes in tablet form. Depending on the dose, it is taken by mouth either daily or weekly. A liquid form of the medication is also available to be taken weekly for people who have difficulty swallowing tablets.
- It must be taken first thing in the morning at least 30 minutes before you eat or drink anything (other than water). You must wait at least 30 minutes after taking the medication before eating or drinking anything other than water or taking any medications. Food, beverages, and medications can interact with Fosamax and prevent it from being absorbed into the body.
- Take it with a full glass of plain water only (not coffee, juice, soda, or even mineral water). With liquid Fosamax, you should follow the dose with at least a quarter of a cup of plain water.
- Swallow the tablets whole with a full glass of water while sitting or standing upright. You must not lie down until you have waited at least 30 minutes after the dose and after you have eaten something. The tablets should not be chewed, broken, or sucked on. These precautions are necessary to prevent it from irritating your esophagus.
- You need to make sure that you get enough calcium and vitamin D while taking it, as the medication cannot build bone without these things.
- For the medication to work properly, it must be taken as prescribed. It will not work if you stop taking it.
The dosage that your healthcare provider recommends will vary, depending on a number of factors, including:
- Whether you prefer to take Fosamax daily or monthly
- Whether you are treating or preventing osteoporosis or treating Paget's disease
- Other medications you may be taking
- Other medical conditions you may have.
As is always the case, do not adjust your dose unless your healthcare provider specifically instructs you to do so.
As with any medicine, side effects are possible with Fosamax. However, not everyone who takes the drug will experience side effects. In fact, most people tolerate it quite well. If side effects do occur, in most cases, they are minor and either require no treatment or can easily be treated by you or your healthcare provider. Serious side effects are less common.
Common side effects include, but are not limited to:
- Abdominal pain (stomach pain)
- Bone, muscle, or joint pain
- Indigestion or heartburn.
(Click Fosamax Side Effects to learn more, including potentially serious side effects that you should report immediately to your healthcare provider.)
Drug Interactions With Fosamax
What Should I Tell My Healthcare Provider?
You should talk with your healthcare provider prior to taking Fosamax if you have:
- A narrowing of the esophagus (an esophageal stricture)
- Difficulty swallowing
- Low blood calcium (hypocalcemia)
- An inability to sit upright or stand for 30 minutes
- Kidney disease, including kidney failure (renal failure)
- Difficulty swallowing or other problems with your esophagus
- Any allergies, including allergies to food, dyes, or preservatives.
Also, let your healthcare provider know if you are:
- Pregnant or thinking of becoming pregnant
- Breastfeeding
- Planning to have a dental procedure.
Make sure to tell your healthcare provider about all medicines you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
What If I Take an Overdose of Fosamax?
People who take too much Fosamax may have overdose symptoms that could include:
- Upset stomach
- Heartburn or indigestion
- Ulcers
- Low levels of calcium or phosphate in the blood.
If you happen to overdose, seek immediate medical attention.
Fosamax tablets should be stored at room temperature, away from moisture and heat. Keep Fosamax and all other medications out of the reach of children.
What Should I Do If I Miss a Dose?
If you forget to take your weekly dose of Fosamax, take your dose on the first morning that you remember, and continue with your regular dosing schedule (do not change the day you normally take Fosamax). However, do not take two doses of the medication in one day.
If you take Fosamax daily and you forget a dose, simply skip the missed dose. Do not take a double dose.
Fosamax tablets are available in the following strengths:
- Fosamax 5 mg (taken daily)
- Fosamax 10 mg (taken daily)
- Fosamax 40 mg (taken once daily for Paget's disease)
- Fosamax 35 mg (taken weekly)
- Fosamax 70 mg (taken weekly).
Liquid Fosamax is also available -- Fosamax 70 mg oral solution (taken weekly). Each bottle contains one dose (70 mg) of the medication in a raspberry-flavored liquid. Weekly Fosamax also comes in tablets that contain a week's worth of vitamin D
(see Fosamax Plus D).
At this time, both brand-name and generic versions of Fosamax are licensed for sale in the United States
(see Generic Fosamax).
