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Alendronic acid

About alendronic acid

Alendronic acid is a type of medicine called a bisphosphonate. Bisphosponates are prescribed to help your bones stay as strong as possible. Taking alendronic acid can help if you have, or are at risk of developing, osteoporosis. This is a condition that causes your bones to get weaker and be more likely to break.

Osteoporosis can happen for many reasons, but you are more likely to get it if:

  • you're a woman who has been through the menopause
  • you take steroids, such as prednisolone, every day for a long time (which means 3 months, or longer)
  • you've had a certain type of cancer treatment – some treatments can increase your risk of developing osteoporosis. Your oncology doctor or nurse will discuss this with you

Talk to your doctor if you are worried about the health of your bones because of the medicines you take, or changes to your hormone levels because of the menopause.

Alendronic acid is only available on prescription. You can take it as a standard tablet, a soluble tablet that dissolves in water, or as a liquid that you drink.

Who can and cannot take alendronic acid

Alendronic acid can be taken by most adults aged 18 and over. It's sometimes prescribed for children with osteoporosis.

Do not give it to children under the age of 18 unless it's prescribed by a doctor.

Alendronic acid is not suitable for some people. To make sure it's safe for you, tell your doctor if you:

  • have ever had an allergic reaction to alendronic acid or any other medicine
  • have problems digesting food, swallowing or other problems with your food pipe (oesophagus)
  • have taken alendronic acid before but it made you feel dizzy and unable to stand or sit upright for at least 30 minutes after taking it
  • have low calcium levels in your blood – alendronic acid sometimes causes low blood calcium, so your calcium levels could become even lower
  • have kidney problems
  • have cancer, or are having chemotherapy or radiotherapy
  • have problems with your teeth, or are waiting for dental treatment such as having a tooth out
  • smoke, or used to smoke – this may increase your risk of dental problems
  • are pregnant, trying to get pregnant or breastfeeding

How and when to take alendronic acid

Follow your doctor's instructions about how and when to take your medicine.

The usual dose of alendronic acid for adults is 70mg taken once a week. There is also a 10mg tablet you take once a day.

You will usually take alendronic acid once a week:

  • as a standard tablet
  • as a liquid that you drink
  • as a tablet that dissolves in water (dispersible)

Whether you take alendronic acid daily or weekly, you need to take your medicine at the same time each day or day of the week. If it's weekly, choose a day that suits your routine.

How to take alendronic acid

It's important to follow the instructions for this medicine very carefully. If you do not, it may not work or it could irritate and damage your food pipe as you swallow it.

The best time to take your medicine is usually 30 minutes before you have breakfast. Take it on an empty stomach, before you have anything to eat or drink (other than plain tap water) and before you take any other medicines that you swallow.

Alendronic acid works best on an empty stomach because your body can absorb it properly.

It's important to take alendronic acid while you're sitting up or standing. Try to stay upright for 30 minutes after taking your medicine – you can be sitting, standing or walking.

Side effects

Like all medicines, alendronic acid can cause side effects in some people, but many people have no side effects, or only minor ones.

These common side effects happen in more than 1 in 100 people. Talk to your doctor or pharmacist if they bother you or do not go away:

  • constipation
  • diarrhoea
  • feeling dizzy (or signs of vertigo)
  • headaches, muscle or joint pain
  • swollen joints, hands or legs
  • indigestion, bloating or wind
  • itching or a mild rash
  • feeling sleepy or tired
  • hair loss

Serious side effects

Some people may have serious side effects when taking alendronic acid. These include heartburn (or heartburn that gets worse), problems or pain when swallowing, or chest pain. These may be signs of ulcers in your food pipe (oesophagus). If this happens, stop taking alendronic acid and speak to a doctor.

Other serious side effects are rare, but call a doctor straight away if you have:

  • a loose tooth, mouth sores, or swelling or pain in your mouth or jaw – contact your dentist as well as your doctor, as this could be a sign of damage to your jaw bone
  • pain, weakness or discomfort in your thigh, hip or groin – this happens rarely but may be an early sign of a broken thigh bone
  • severe pain in your joints, muscles or bones
  • ear pain, discharge from your ear or an ear infection – these can be signs of damage to the bones in your inner ear
  • black or red poo – these can be signs of an ulcer or bleeding from your gut
  • blurred vision, painful or red eyes – these can be signs of swelling of the eye
  • muscle cramps or spasms, a tingling sensation in your fingers or around your mouth – these can be symptoms of low calcium levels in your blood

In rare cases, alendronic acid may cause a serious allergic reaction (anaphylaxis).

These are not all the side effects of alendronic acid. For a full list, see the leaflet inside your medicine packet.

How to cope with side effects of alendronic acid

What to do about:

  • constipation – eat more high-fibre foods such as fresh fruit, vegetables and cereals, and drink plenty of water. Try to increase your level of exercise if you can, by going for a daily walk or run. If this does not help, talk to your pharmacist or doctor. This short video explains more about how to treat constipation.
  • diarrhoea – drink plenty of water. Speak to a pharmacist if you have signs of dehydration, such as peeing less than usual or having dark, strong-smelling pee. Do not take any medicines to treat diarrhoea without speaking to a pharmacist or doctor.
  • feeling dizzy – stop what you're doing, and sit or lie down until you feel better. Do not drive or use tools or machinery until your dizziness has gone.
  • headaches, muscle or joint pain – make sure you rest and drink plenty of fluids. Try not to drink too much alcohol. Ask your pharmacist to recommend a painkiller, and talk to your doctor if the pain lasts longer than a week or is severe.
  • swollen joints, hands or legs – try to rest. Avoid standing for long periods if you have swollen legs, and put your feet on a stool or cushion to raise your legs when you're sitting. Talk to your doctor if the swelling is severe or lasts longer than a week.
  • indigestion, bloating or wind – make sure you follow the directions for taking alendronic acid carefully and remain upright for at least 30 minutes after taking it. It might help to eat smaller meals more often. You could also try eating and drinking more slowly, and increase your level of exercise if you can. If the symptoms get worse, contact your doctor straight away.
  • itching or a mild rash – it may help to take an antihistamine , which can reduce these symptoms. You can buy antihistamines from a pharmacy but check with the pharmacist to see what type is suitable for you when taking this medicine.
  • feeling sleepy or tired – do not drive, cycle or use tools or machinery, if you're feeling tired. Try not to drink any alcohol, as this will make you feel more tired.
  • hair loss – thinning hair or mild hair loss in itself can be stressful but it is not usually a sign of anything to worry about. Talk to your pharmacist or doctor if you're concerned. Some hair loss treatments are available.

Pregnancy and breastfeeding

Alendronic acid is not recommended during pregnancy. This is because there has not been enough research into its safety.

Alendronic acid and breastfeeding

It's generally OK to take alendronic acid while breastfeeding. This is because we only expect very small amounts to pass into breast milk. It may not be suitable in a very small number of cases. Check with your doctor about what's best for you and your baby.

Cautions with other medicines

If you've been prescribed alendronic acid, do not take other medicines that you have to take by mouth (orally) at the same time. This is because it enters the stomach, soaks up the alendronic acid and stops it working properly.

If you do need to take another medicine by mouth, wait for at least 30 minutes.

Some medicines can affect the way alendronic acid works.

Tell your doctor if you're taking:

  • supplements or multivitamins containing calcium, iron, magnesium or zinc
  • antacids to relieve indigestion or heartburn
  • laxatives containing magnesium
  • cancer medicines such as bevacizumab or thalidomide
  • steroids such as prednisolone or dexamethasone – these may increase the risk of damage to your jaw bone
  • non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, which can increase the risk of irritating your food pipe, stomach or gut. Taking low-dose aspirin is OK
  • antibiotics such as gentamicin, amikacin or tobramycin – these can lower the calcium in your blood
  • deferasirox, a medicine used to remove excess iron from the body – this may increase the risk of bleeding from your gut

Also tell your doctor if you are having chemotherapy.

There's very little information about taking herbal remedies and supplements with alendronic acid.

Related links

Osteoporosis — Link to Related Condition

HealthUnlocked: alendronic acid forum — Link to Useful Resource

Oral Health Foundation: charity — Link to Useful Resource

Royal Osteoporosis Society: charity — Link to Useful Resource

HealthUnlocked contains information from NHS Digital, licensed under the current version of the Open Government Licence

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3,367 public posts

Alendronic acid

I have been taking alendronic acid for over 5 years. When I spoke with my doctor about having a break from it, he seemed to think I could go to 7 years. Is this correct?
I have been taking alendronic acid for over 5 years. When I spoke with my doctor about having a break from it, he seemed to think I could go to 7 years. Is this correct?
Delphy profile image
Delphy
in Bone Health

Alendronic acid quandary

My doctor has put me on Alendronic acid tablets and 1200 mg calcium supplements(Adcal D3). After the first six days I had constipation and consequent haemorrhoids. I took the alendronic acid and a day later that resulted in headaches, muscle tightness in the legs and arms and fatigue.
My doctor has put me on Alendronic acid tablets and 1200 mg calcium supplements(Adcal D3). After the first six days I had constipation and consequent haemorrhoids. I took the alendronic acid and a day later that resulted in headaches, muscle tightness in the legs and arms and fatigue.
Redtime profile image
Redtime
in Bone Health

Medication on GPA

Im on 4 500mg mycophenolate daily, calceous and alendronic acid. I was tapered off predisinolone and stopped in May 2021 and also stopped co tricamazole.
Im on 4 500mg mycophenolate daily, calceous and alendronic acid. I was tapered off predisinolone and stopped in May 2021 and also stopped co tricamazole.
Mingtai profile image
Mingtai
in Vasculitis UK
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Treatment for Osteoporosis

I have refused Alendronic acid because of side effects - Osteo necrosis of the jaw, principally. Phyllis Wilson
I have refused Alendronic acid because of side effects - Osteo necrosis of the jaw, principally. Phyllis Wilson
Pheewills profile image
Pheewills
in Bone Health

Alternative to Alendronic Acid

Hi, I’m new to this and wonder if anyone can give me any advice on what I should be taking, as I’m really confused. I am taking Anastrozole after having breast cancer, I then had a bone density scan and was told I had Osteopenia. I am 67 yrs old AP Spine(L1-L4) T-score. -1.4. Z -score 0.4 Femoral
Hi, I’m new to this and wonder if anyone can give me any advice on what I should be taking, as I’m really confused. I am taking Anastrozole after having breast cancer, I then had a bone density scan and was told I had Osteopenia. I am 67 yrs old AP Spine(L1-L4) T-score. -1.4. Z -score 0.4 Femoral
Lucy1578 profile image
Lucy1578
in Bone Health

Should my husband take Alendronic Acid

Hi, my husband is being advised to go on Alendronic Acid because he has brittle bones and two fractures in his spine. He has stage 4 prostate cancer and also broke his femur last Christmas 2021, his femur has not healed.
Hi, my husband is being advised to go on Alendronic Acid because he has brittle bones and two fractures in his spine. He has stage 4 prostate cancer and also broke his femur last Christmas 2021, his femur has not healed.
Darcra profile image
Darcra
in Bone Health

Bone Scan advice

I'm on Alendronic Acid too. I have been on Letrozole since my Mastectomy in June 2019. I had a bone scan then which is standard when starting something like Letrozole as it increases osteoporosis risk. I was fine then so I'm not due for another one for 2 years when hopefully I will stop Letrozole .
I'm on Alendronic Acid too. I have been on Letrozole since my Mastectomy in June 2019. I had a bone scan then which is standard when starting something like Letrozole as it increases osteoporosis risk. I was fine then so I'm not due for another one for 2 years when hopefully I will stop Letrozole .
Jigsawlass profile image
Jigsawlass
in PMRGCAuk

Alendronic Acid and Evacal D3

Hi is anyone on these two medications and getting Stomach aches/headaches and feeling nauseous? I have been placed on these 6 weeks ago and I'm not feeling great! Even thought at one stage that I had Covid symptoms. (Didn't/Don't as get tested daily for work!) Have got in touch with my Rheumy dept and
Hi is anyone on these two medications and getting Stomach aches/headaches and feeling nauseous? I have been placed on these 6 weeks ago and I'm not feeling great! Even thought at one stage that I had Covid symptoms. (Didn't/Don't as get tested daily for work!) Have got in touch with my Rheumy dept and
scorpiojack profile image
scorpiojack
in NRAS

Alendronic Acid or Teriperatide

I have refused Alendronic Acid.
I have refused Alendronic Acid.
Pheewills profile image
Pheewills
in Bone Health

Painful shoulder blade.

I had already taken my first dose of Alendronic acid and was having a reaction to it in the form of shoulder blade pain. 8 days later I still have the pain and am needing to take 60 mg of Dihydracodeine to be comfortable at least twice daily as well as applying heat pads regularly .
I had already taken my first dose of Alendronic acid and was having a reaction to it in the form of shoulder blade pain. 8 days later I still have the pain and am needing to take 60 mg of Dihydracodeine to be comfortable at least twice daily as well as applying heat pads regularly .
Pandora2 profile image
Pandora2
in PMRGCAuk

Diverse medications

Ive been given alendronic acid ( Binosto) but my friends doctor said Prolia is much better .
Ive been given alendronic acid ( Binosto) but my friends doctor said Prolia is much better .
Killbill234 profile image
Killbill234
in Bone Health

Osteoporosis

My rheumatologist wants me to take alendronic acid which I’m worried about. I wonder if anyone could help with a couple of questions: do I take this before or after lansoprazole in the morning and should I delay some dental work (crown and filling), also what to expect?
My rheumatologist wants me to take alendronic acid which I’m worried about. I wonder if anyone could help with a couple of questions: do I take this before or after lansoprazole in the morning and should I delay some dental work (crown and filling), also what to expect?
Avon14 profile image
Avon14
in PMRGCAuk

Coming off Pred

I’m on Alendronic acid once a week and Advil daily. Should I stop these too? Thanks. Bob UK.
I’m on Alendronic acid once a week and Advil daily. Should I stop these too? Thanks. Bob UK.
Bobwif profile image
Bobwif
in PMRGCAuk

Alendronic Acid and Hypertension

I am on treatment for hypertension and my blood pressure soared after taking Alendronic Acid. According to some medical papers, it should be given with care to patients with hypertension.
I am on treatment for hypertension and my blood pressure soared after taking Alendronic Acid. According to some medical papers, it should be given with care to patients with hypertension.
GFochriw19 profile image
GFochriw19
in PMRGCAuk

Feeling really down

Also, due to the fact that the Omeprazole will affect my bones, I am taking Adcal and Alendronic Acid, as I already have osteoporosis. Had anybody else taken these without unpleasant side effects? I am feeling so tired and in pain, and I so want to enjoy my son's visit later in the year. Jenny
Also, due to the fact that the Omeprazole will affect my bones, I am taking Adcal and Alendronic Acid, as I already have osteoporosis. Had anybody else taken these without unpleasant side effects? I am feeling so tired and in pain, and I so want to enjoy my son's visit later in the year. Jenny
27-359 profile image
27-359
in My Ovacome

Omeprazole

It seems to be recommended with steroids and alendronic acid - is it necessary? I have been encouraged to take AA due to osteopenia but, again, not entirely sure if I need it. Any information appreciated. Thank you.
It seems to be recommended with steroids and alendronic acid - is it necessary? I have been encouraged to take AA due to osteopenia but, again, not entirely sure if I need it. Any information appreciated. Thank you.
Miserere profile image
Miserere
in PMRGCAuk

Alendronic Acid - any experience

Dr has now prescribed Alendronic Acid and having read the side effects especially on feeling unwell and jaw problems it seems like exchange a hypothetical potential bone issue for a whole loss of prevelant side effects.
Dr has now prescribed Alendronic Acid and having read the side effects especially on feeling unwell and jaw problems it seems like exchange a hypothetical potential bone issue for a whole loss of prevelant side effects.
Anarion1 profile image
Anarion1
in PMRGCAuk

Dental problems & alendronic acid…anybody had ONJ (necrosis of jaw) please?

She says that due to two years of taking Alendronic Acid, I am at medium to high risk of MRONJ, or necrosis of the jaw. She explains how awful that is. (I googled it, no way do I want it!) She says she will add me to 3 month waiting list for extraction while I choose what to do.
She says that due to two years of taking Alendronic Acid, I am at medium to high risk of MRONJ, or necrosis of the jaw. She explains how awful that is. (I googled it, no way do I want it!) She says she will add me to 3 month waiting list for extraction while I choose what to do.
Pixix profile image
Pixix
in PMRGCAuk

Feeling very emotional

Decided to stop Alendronic acid today owing to all side affects. Feeling emotional it just seems one thing after another 😭😭
Decided to stop Alendronic acid today owing to all side affects. Feeling emotional it just seems one thing after another 😭😭
Doughnut61 profile image
Doughnut61
in NRAS

Update after consultant visit

As PMR pro suspected I have now been put on Alendronic acid, a liquid bottle of 70mg made up with 30mg water to 100mg weekly due to recent DEXA scan.
As PMR pro suspected I have now been put on Alendronic acid, a liquid bottle of 70mg made up with 30mg water to 100mg weekly due to recent DEXA scan.
Pawscat11 profile image
Pawscat11
in PMRGCAuk
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