Generic name: Alendronate

Why is this medication prescribed?
Alendronate is used to prevent and treat postmenopausal osteoporosis (bone weakening) or Paget's disease. It prevents or slows weakening of bone.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

How should this medicine be used?
Alendronate comes as a tablet to take by mouth. It should be taken once a day in the morning on an empty stomach. Alendronate should be taken with a full glass (6-8 ounces) of plain water. Wait at least 30 minutes after taking alendronate before you eat, drink, or take other medications. Do not take alendronate with mineral water, coffee, orange juice, milk, or other dairy products. Do not suck or chew the tablet; swallow the tablet whole. Do not lie down for at least 30 minutes after taking alendronate. Standing or sitting upright helps you get the full dose and decreases heartburn or the risk of injury to your esophagus.

Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take alendronate exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Do not stop taking alendronate without talking to your doctor.

What special precautions should I follow?
Before taking alendronate,

• tell your doctor and pharmacist if you are allergic to alendronate or any other drugs.
• tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially antacids, aspirin products, calcium products, and vitamins.
• tell your doctor if you have or have ever had abnormalities of your esophagus; upper gastrointestinal disease such as ulcers, gastritis, heartburn, chronic stomach problems, or duodenitis; a history of neuroleptic malignant syndrome (high temperature with rigid muscles and abnormal consciousness); or below normal calcium levels in your blood or if you are unable to stand or sit upright for 30 minutes.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking alendronate, call your doctor.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking alendronate.
• be aware that you should not drink alcoholic beverages while you are taking this drug.

What special dietary instructions should I follow?
It is important that you get enough calcium and vitamin D while you are taking alendronate. Your doctor may prescribe supplements if your dietary intake is not enough.

Remember that alendronate should be taken with at least 6-8 ounces of water. Food, drinks, and other drugs (including vitamins, calcium, and vitamin D) should not be taken for at least 30 minutes after taking alendronate.

What should I do if I forget a dose?
If you miss a dose, do not take it later in the day. Continue your usual schedule of one tablet once a day the next morning.

What side effects can this medication cause?
Although side effects from alendronate are not common, they can occur. Tell your doctor if any of these symptoms are severe or do not go away:

• gas
• bloating
• constipation
• diarrhea
• stomach irritation or upset stomach
• acid regurgitation (reflux)
• stomach pain
• headache
• muscle or bone pain

If you experience any of the following symptoms, call your doctor immediately:

• difficulty swallowing
• pain during swallowing
• chest pain
• new or worsening heartburn
• vomiting blood

What storage conditions are needed for this medicine?
Keep this medication in the container it came in, tightly closed, and out of reach of children. You may ask your pharmacist to put this medication in a container without a child-resistant cap, but be sure to keep it out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose
In case of overdose, call your local poison controlcenter at 1-800-222-1222. If the victim has collapsedor is not breathing, call local emergency services at911.

Symptoms of overdose may include:

• upset stomach
• heartburn
• bloody vomit
• vomiting material that looks like coffee ground
• stomach pain

What other information should I know?
Keep all appointments with your doctor and the laboratory.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.