Fosamax checklist: What to know before and while taking alendronate

Fosamax (alendronate) is a common drug for osteoporosis. It helps strengthen bone and lower fracture risk, but it needs specific habits to work safely. Use this checklist as a simple, practical guide so you get the benefit and avoid common problems.

Before you start

Talk with your doctor about these points and tick them off:

• Confirm the diagnosis: ask for a DEXA scan result and what target you’re aiming for.
• Check kidney function: alendronate is not recommended if your kidney function is poor (ask about creatinine clearance).
• Review other meds and supplements: calcium, iron, antacids, and some vitamins can cut Fosamax absorption.
• Dental check: if you need extractions or dental implants, get care sorted first—there’s a small risk of jaw bone issues with bisphosphonates.
• Pregnancy/breastfeeding: don’t use Fosamax if you’re pregnant or nursing. Discuss alternatives if relevant.

Daily use checklist & safety tips

Follow these steps every dosing day. They really matter.

• Take it first thing in the morning on an empty stomach.
• Use a full glass of plain water. Do not use coffee, juice, or other drinks.
• Swallow the tablet whole—do not crush or chew it.
• Wait at least 30 minutes before eating, drinking anything else, or taking other meds or supplements. Calcium and antacids block absorption.
• Stay upright (sitting or standing) for 30 minutes after taking it to protect your esophagus.
• If you miss a dose, take it the next morning. Don’t take two doses the same day.

Watch for warning signs. Call your doctor if you get new or worsening:

• Severe heartburn, trouble swallowing, or chest pain—these can signal esophageal irritation.
• New, unusual thigh, hip, or groin pain—rare atypical femur fractures have been reported.
• Jaw pain, loose teeth, or slow-healing wounds in the mouth—discuss with both your dentist and prescriber.
• Severe stomach pain, allergic reactions, or unexpected symptoms.

Follow-up and duration: plan a DEXA test and clinical review after 1–2 years, then at intervals your doctor recommends. Many adults take Fosamax for 3–5 years then reassess whether to continue or try a drug holiday. Keep vitamin D and calcium levels in the recommended range—your doctor will advise amounts based on your diet and labs.

Last practical notes: store tablets at room temperature, away from moisture. If you’re unsure about interactions or dental procedures, pause and ask your prescriber. Small habits—taking the pill with plain water, staying upright, and spacing other meds—make Fosamax far safer and more effective.