Fosamax® was the first prescription medicine FDA approved for treatment of postmenopausal osteoporosis in 1995. In 2008, generic versions of Fosamax, which is alendronate became available the United States. Because of a large cost differential between brand and generic tablets, if you receive a prescription for Fosamax most likely it will be filled as generic alendronate. Branded Fosamax 70 milligrams in combination with vitamin D is available with a choice of two different doses of vitamin D, either 2800 IU or 5600 IU that is taken once weekly

Fosamax is in the class of medicines called bisphosphonates. It works by decreasing the rate that bone is broken down. This reduction in bone turnover results in stabilizing or building up bone mass that results in decreasing risk of fractures. In clinical trials, Fosamax versus placebo was effective in decreasing the risk of fractures at all sites including spine, hip, and nonspine sites.

Tablet Requires Special Dosing Instructions

Fosamax is a tablet taken by mouth usually once a week. Because Fosamax is poorly absorbed if you eat or drink something at the same time, special instructions for taking the medicine need to be followed:

Fosamax is taken first thing in the morning on an empty stomach with 6 to 8 ounces of plain water. You must wait one half an hour before taking any food, drinks, or other medicines. During this time you also must remain upright to help ensure the medicine reaches the stomach and causes no irritation to the esophagus.

Who Should Consider Fosamax?

The indications for taking Fosamax are that you are high risk for breaking a bone or taking steroid medicines that put you at higher risk for breaking a bone. Fosamax is approved for use in both men and women. The goal of taking this medicine is to decrease your risk of breaking a bone.

Side Effects

As with any medicine, side effects are possible when taking Fosamax. The most common side effects are digestive system problems including nausea, heartburn, diarrhea, or constipation.

A “Medication Guide” that is included with the dispensing of Fosamax and all the bisphosphonate-class medicines details 5 potential serious side effects:

  1. Esophagus problems
  2. Low calcium levels in your blood (hypocalcaemia)
  3. Severe jaw bone problems (osteonecrosis)
  4. Bone, joint, or muscle pain
  5. Unusual thigh bone fractures

Overall Fosamax is well tolerated and these serious side effects occur infrequently. Read more about osteonecrosis of the jaw and atypical femur fractures.

How Long Should You Take Fosamax?

The length of use of Fosamax and all bisphosphonates is being debated and is controversial. A total of 10 years of use in clinical trials for Fosamax is the longest research evidence of all bisphosphonates. limited to guide this The recent FDA labeling includes “The optimal duration of use has not been determined. Patients should have the need for continued therapy re-evaluated on a periodic basis.” Find additional information under the topic “drug holiday.”

Discuss with your doctor or healthcare practitioner your individual risk and whether this medicine would be appropriate for you to use.

Other Resources:

Fosamax Plus D Medication Guide