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BISPHOSPHONATE
Fosamax (alendronate) and Fosamax Plus D (alendronate sodium/cholecalciferol) are prescription medications approved by the U.S. Food and Drug Administration (FDA) to treat osteoporosis in women after menopause. They are also used to increase bone mass in men with osteoporosis.
These insights are based on 3,463 comments about Fosamax from MyOsteoTeam members. These are the experiences of a small number of people and are not meant to be medical advice.
Benefits:
Considerations:
Fosamax is a type of medicine called a bisphosphonate. It binds to bone and slows osteoclasts, the cells that break down bone. This reduces bone breakdown and helps increase bone mass.
Fosamax Plus D contains alendronate and vitamin D3, also called cholecalciferol. The alendronate slows the breakdown of bone. Vitamin D3 helps the body absorb calcium and phosphate and is needed for normal bone formation.
In women with osteoporosis after menopause, both Fosamax and Fosamax Plus D increase bone mass and reduce the risk of fractures, including hip and spinal fractures.
Doctors prescribe Fosamax to:
Doctors prescribe Fosamax Plus D to:
Fosamax and Fosamax Plus D tablets should be taken on an empty stomach after getting up for the day and before taking the first food, drink, or any other medicine.
Take the tablet while sitting or standing. Swallow it with a full glass, about 6 to 8 ounces, of plain water. Do not chew or suck the tablet. Do not take it with mineral water, coffee, tea, soda, or juice.
After taking Fosamax or Fosamax Plus D, wait at least 30 minutes before lying down, eating or drinking anything other than plain water, or taking other medicines, including antacids, calcium, vitamins, or supplements. Do not take either medicine at bedtime.
For treatment of osteoporosis, Fosamax is taken as 70 milligrams once a week or 10 milligrams once a day.
Fosamax Plus D is taken once a week.
The recommended dose is one tablet containing 70 milligrams of alendronate with either 2,800 international units or 5,600 international units of vitamin D3.
For most people with osteoporosis, the 70 milligram/5,600 international unit tablet is the appropriate dose.
This information is based on the prescribing information. Always follow your healthcare provider’s guidance.
These insights are based on 3,463 comments about Fosamax from MyOsteoTeam members. These are the experiences of a small number of people and are not meant to be medical advice.
Members who use Fosamax often say that establishing a routine, tracking your symptoms, and regularly checking in with a doctor matter a lot. Many members also describe balancing medication with exercise, calcium, and vitamin D, while paying close attention to stomach, throat, jaw, or bone pain that may need medical follow-up.
Follow the dosing instructions closely.
“I take Fosamax first thing in the morning with plain water, on the same day each week, before eating or taking other medicines. I make sure to stay upright and wait before eating.”
Talk to your doctor if swallowing, stomach, or throat problems start.
“I took Fosamax, and it caused difficulty swallowing food with a choking feeling, along with horrible heartburn and acid reflux.”
Keep up exercise, calcium, and vitamin D alongside treatment.
“My doctor prescribed alendronate and told me to make sure I get enough calcium and vitamin D. I track my intake and keep up with walking and weight-bearing exercise.”
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In clinical studies of Fosamax and Fosamax Plus D, the most common side effects occurred in between 3 percent and 7 percent of people, depending on the study. These included:
Fosamax and Fosamax Plus D can cause serious side effects that may require immediate medical attention. These include:
Get medical help right away if you think you are having a serious reaction.
Low blood calcium levels must be treated before starting Fosamax or Fosamax Plus D. Other conditions that affect mineral levels, such as vitamin D deficiency, should also be treated.
Before taking Fosamax or Fosamax Plus D, tell your doctor if you:
Before taking Fosamax Plus D, also tell your doctor if you have sarcoidosis, leukemia, or lymphoma. These conditions can affect vitamin D levels.
Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements. Be sure to mention:
Do not take Fosamax or Fosamax Plus D if you:
Fosamax is also FDA approved to treat Paget’s disease of bone. Fosamax Plus D is not used for this condition.
If you miss a once-weekly dose of Fosamax or Fosamax Plus D, take one dose the next morning after you remember. Do not take two doses on the same day. Then return to your regular once-weekly schedule.
Stop taking Fosamax or Fosamax Plus D if you become pregnant, and contact your doctor.
If you are breastfeeding or plan to breastfeed, talk with your doctor. It is not known whether alendronate passes into human breast milk. With Fosamax Plus D, vitamin D3 and some of the substances the body makes from it can pass into breast milk.
These answers are fact-checked by our editorial staff.
How effective is Fosamax and Fosamax Plus D for osteoporosis?
Fosamax and Fosamax Plus D are used to treat osteoporosis in women after menopause. Both increase bone mass and reduce the risk of fractures, including hip and spinal fractures.
Here are the results of several studies on Fosamax:
Fosamax Plus D contains 70 milligrams of alendronate along with vitamin D3. It increases bone mass and reduces the risk of hip and spinal fractures in women with osteoporosis after menopause.
The best length of treatment with Fosamax or Fosamax Plus D has not been determined.
How long do Fosamax and Fosamax Plus D take to work for osteoporosis?
In studies with Fosamax, increases in bone mineral density were seen as early as three months after starting treatment and continued during three years of treatment. In a one-year study, women taking Fosamax 70 milligrams once a week had an average 5.1 percent increase in bone mineral density in the lower spine.
Fosamax Plus D contains alendronate plus vitamin D3. It increases bone mass and reduces fracture risk, but a specific time when its bone-strengthening effect begins is not stated.
Do Fosamax and Fosamax Plus D interact with other medicines?
Yes. Fosamax and Fosamax Plus D can interact with some medicines and supplements.
Calcium supplements, antacids, and some medicines that contain minerals can reduce how much alendronate your body absorbs. Wait at least 30 minutes after taking Fosamax or Fosamax Plus D before taking other medicines by mouth.
Aspirin and nonsteroidal anti-inflammatory drugs, also called NSAIDs, can irritate the stomach and digestive tract. Use caution when taking them with Fosamax or Fosamax Plus D.
Fosamax Plus D contains vitamin D3, so it has some additional interactions. Olestra, mineral oil, orlistat, cholestyramine, and colestipol can reduce vitamin D absorption. Anti-seizure medications, cimetidine, and thiazides may increase how quickly the body breaks down vitamin D.
Tell your healthcare provider about all medicines, vitamins, and supplements you take.
On MyOsteoTeam, people share their experiences with osteoporosis, get advice, and find support from others who understand.
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