Binosto (Alendronate Sodium) for Osteoporosis

Binosto (alendronate sodium) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to treat osteoporosis in women after menopause. It is also approved to increase bone mass in men with osteoporosis.

How Binosto Works and How It’s Taken

Binosto is a type of medicine called a bisphosphonate. It slows the activity of cells called osteoclasts, which break down bone. This helps reduce bone loss and can increase bone mass.

In women with osteoporosis after menopause, Binosto helps reduce the chance of hip and spine fractures.

Doctors prescribe Binosto to:

Treat osteoporosis in women after menopause
Increase bone mass in men with osteoporosis

Binosto comes as an effervescent tablet that must be dissolved in water before you take it. It is taken once a week.

Take Binosto after you get up for the day and at least 30 minutes before your first food, drink, or other medicine. Take it while sitting or standing.

Do not swallow, chew, or suck on the tablet. Do not dissolve it in mineral water, flavored water, coffee, tea, soda, or juice.

After taking Binosto, wait at least 30 minutes before eating, drinking anything other than plain water, or taking other medicines. Do not lie down for at least 30 minutes and until after you have eaten your first food of the day.

Typical Dosing for Osteoporosis

The recommended dose of Binosto is one 70-milligram effervescent tablet once weekly.

This information is based on prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

Binosto Side Effects

In clinical studies of Binosto for the treatment of osteoporosis in postmenopausal women, the most common side effects happened in about 3 percent to 7 percent of people. These include:

Abdominal (stomach) pain
Acid regurgitation (acid backing up into the throat)
Constipation
Nausea
Dyspepsia
Diarrhea
Bone, muscle, or joint pain

Serious Side Effects and Warnings

Binosto can cause serious side effects that may require immediate medical attention. These include:

Upper gastrointestinal (GI) irritation and injury — Inflammation, ulcers, or erosions in the esophagus can occur, sometimes with bleeding, narrowing, or rarely a tear.
Hypocalcemia — Low calcium levels in the blood can affect other minerals in the body, like vitamin D deficiency.
Severe bone, joint, or muscle pain — The pain can be severe and sometimes disabling.
Osteonecrosis of the jaw — Jawbone damage is often linked with dental procedures or infection and delayed healing.
Atypical femur fractures — Unusual thigh bone fractures can happen with little or no trauma; new thigh or groin pain can be a warning sign.

Get medical help right away if you think you are having a serious reaction.

What To Know Before Taking Binosto

Before starting Binosto, low calcium levels in your blood, called hypocalcemia, must be treated.

Before taking Binosto, tell your doctor if you:

Have trouble swallowing
Have stomach or digestive problems
Have low calcium levels in your blood
Plan to have dental surgery or teeth removed
Have kidney problems
Have trouble absorbing minerals from your stomach or intestines
Have been told to limit how much salt you eat
Are allergic to alendronate sodium or any ingredient in Binosto
Are pregnant, planning to become pregnant, or think you may be pregnant
Are breastfeeding or plan to breastfeed

Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements. Be sure to mention if you take:

Calcium
Antacids
Aspirin
Nonsteroidal anti-inflammatory drugs (NSAIDs)

Do not take Binosto if you:

Have certain problems with your esophagus, the tube that connects your mouth to your stomach
Cannot sit or stand upright for at least 30 minutes
Have trouble swallowing liquids
Have low calcium levels in your blood
Are allergic to Binosto or any of its ingredients

If you miss your weekly dose, take one dose the next morning after you remember. Do not take two doses on the same day. Then go back to taking one dose once a week on your usual day.

If you become pregnant while taking Binosto, stop taking it and contact your healthcare provider. If you are breastfeeding or plan to breastfeed, tell your healthcare provider. It is not known whether alendronate passes into human breast milk or affects a breastfed baby.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Binosto for osteoporosis?

Binosto 70 milligrams is bioequivalent to alendronate sodium 70 milligrams. This means the medicines deliver the same amount of alendronate to the body. The benefits of Binosto are based on clinical studies of alendronate sodium.

In one three-year study of women with osteoporosis after menopause who already had a spine fracture, 7.9 percent of women taking alendronate had a new spine fracture compared with 15 percent taking placebo. Hip fractures occurred in 1.1 percent of women taking alendronate compared with 2.2 percent taking placebo. Wrist fractures occurred in 2.2 percent compared with 4.1 percent.

In other combined studies, 3.2 percent of women taking alendronate had a new spine fracture compared with 6.2 percent taking placebo.

Alendronate also increased bone mineral density, which is a measure of bone strength. In women with osteoporosis after menopause, once-weekly alendronate sodium 70 milligrams increased bone mineral density in the lower spine by an average of 5.1 percent after one year.

In men with osteoporosis, once-weekly alendronate sodium 70 milligrams increased bone mineral density in the lower spine by an average of 2.8 percent compared with placebo after one year.

How long does Binosto take to work for osteoporosis?

The clinical study does not give a specific amount of time for Binosto to start working. In studies of alendronate sodium 10 milligrams taken daily, increases in bone mineral density were seen as early as three months. Studies of once-weekly alendronate sodium 70 milligrams also showed increases in bone mineral density after one year.

What tests or monitoring are needed with Binosto for osteoporosis?

Low calcium levels in the blood must be treated before starting Binosto. Other problems that affect minerals in the body, such as vitamin D deficiency, should also be treated.

If you have one of these conditions, your healthcare provider should monitor your blood calcium levels and watch for symptoms of low calcium during treatment.

If you do not get enough calcium or vitamin D from your diet, your healthcare provider may recommend supplements.