What Are The Side Effects Of Alendronate Sodium In The Body?

When considering any new medication, it’s important to consider potential side effects, to learn proper dosing, and be aware of potential drug interactions. This is equally true for alendronate sodium. While nearly every medication has side effects, knowing the potential side effects is vital to managing your medications.

What Is Alendronate Sodium?

Alendronate sodium is a medication commonly used to treat osteoporosis in both men and women. Osteoporosis is a condition that causes bones to become weak and brittle, creating a risk of fracture. Women who have gone through menopause, those taking certain medications, and the elderly are more likely to develop osteoporosis. Available in both liquid and tablet form, the drug is used to treat bone loss caused by steroid use, prednisone use or Paget’s disease. Alendronate is a medication belonging to the family of bisphosphonates.

How does Alendronate Sodium Work?

Alendronate causes an increase in bone mineral density by eliminating the cells that cause bone degeneration, known as osteoclasts, therefore slowing bone degeneration. By repairing damage from osteoporosis or other bone-depleting conditions or medications, the medication can reduce the risk for fractures, especially in post-menopausal women.

How to Take Alendronate Sodium

Take Alendronate sodium once a day in the morning after rising but before eating or drinking. To best protect the throat, swallow tablets whole with a full glass of water. If using the tablet form, do not suck on or chew the tablets. Because alendronate only works on an empty stomach, it is important not to eat and drink anything other than water for 30 minutes after taking the tablet.

To ensure proper absorption of the medication, remain upright immediately after taking the medication and until after you have eaten. Do not lay down or recline. If you are not able to stay upright for at least 30 minutes, consult your doctor. Taking alendronate sodium before bed or just prior to lying down may prevent the body from absorbing the medication and can cause serious damage to the esophagus.  

Try to take the medication at the same time every day. This medication is most effective when taken regularly. If you miss a daily dose, do not double up the following day. Never take two doses of alendronate sodium on the same day. For those who take alendronate sodium weekly, replace a missed dose by taking it the first morning you remember but do not take two doses on the same day. If you are unsure about replacing a missed dose, contact your physician.

Things to Avoid When Taking Alendronate Sodium

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Certain foods, drinks, and vitamins can negatively impact the body’s ability to absorb alendronate sodium, especially if ingested too soon after taking the drug. From the medicine cabinet, avoid calcium or iron supplements, antacids or vitamins for at least 30 minutes, and ideally up to two hours after dosage. LIkewise, coffee, tea, or calcium-enriched juices can negatively impact your body’s ability to use the medication. Eating too soon after taking the tablet can also negatively impact your body’s ability to absorb the medication.

It is also inadvisable to smoke or drink heavily when using this medication as such activities can exacerbate bone loss.

NSAIDs including aspirin or ibuprofen can affect usage of alendronate sodium. Consult your doctor if you are using any of these medications.

Women who are pregnant or breastfeeding should not take this medication unless under the direction of a doctor.

Recommended Dosage

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For the treatment of current osteoporosis not caused by steroid use in men or women, the typically recommended dosage is one 10 mg tablet one time each day or one 70 mg dose once a week.

When employed as a measure to prevent the onset of osteoporosis, the standard recommended dosage is 5 mg once per day.

For treatment or prevention of osteoporosis induced by steroid or corticosteroid usage in men or women, the recommended dosage is 5 mg once per day. However, for post-menopausal women taking estrogen, it is recommended to increase the dosage to 10 mcg per day.

The highest dosing recommendations are for those suffering with Paget’s disease of the bone. To treat bone loss associated with Paget’s disease, the recommended dosage is 40 mg once a day for six months. This is the recommendation for both men and women.

A number of factors can influence your prescription, and the above dosages reflect the most commonly prescribed amounts. However, if your doctor has recommended a different dosage, it’s important to follow those instructions and refer to your dosing guide.

Side Effects

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Side effects are undesirable effects caused by taking a certain medication. Side effects may be mild, moderate or severe. Most side effects are temporary, but some can be permanent or serious.

If usage of alendronate sodium causes any undesirable side effects, contact your doctor. While most side effects will resolve on their own, some side effects may be signs of an allergic reaction. If you experience side effects including hives, wheezing, difficulty breathing or swelling of the face, lips, tongue or throat, seek medical help immediately.

Serious Side Effects That Require Medical Help

If you experience any of the below side effects when taking alendronate sodium, contact your physician immediately.

  • Delayed healing and infection of mouth and jaw, often occurring after dental work
  • New or unusual pain in the hip or thigh
  • High fever; rash; sores; painful blisters on the skin, mouth, or eyes; or peeling skin
  • Pain or burning in the esophagus or chest pain, difficulty swallowing, pain when swallowing, or new or worsening heartburn
  • Nausea, vomiting to include vomiting blood, abdominal pain, loss of weight or appetite, black or bloody stools

More Common Side Effects

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Abdominal pain or stomach aches are the most commonly experienced side effects associated with alendronate sodium.
Other common side effects that have been reported by at least one percent of users include: 

  • Gas
  • Constipation
  • Diarrhea
  • Bloating
  • Nausea
  • Joint pain or swelling
  • Swelling of the hands or feet
  • Dizziness
  • Headache
  • Eye pain or redness
  • Back pain
  • Weakness

Less Common Side Effects

Side effects that occur less frequently with alendronate sodium include difficulty with swallowing, heartburn, esophageal pain or muscle pain

Rare Side Effects

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Though unusual, some patients have experienced a skin rash when using alendronate sodium. Other patients have rarely developed osteonecrosis, or bone loss in the jaw. Osteonecrosis is often characterized by a delayed healing in the mouth or jaw area, especially after oral surgeries such as a tooth extraction. Those who have pre-existing jaw issues should be extra cautious of any such side effects.

Other Side Effects

A number of side effects have been reported to occur in patients using alendronate sodium, though the exact frequency is unknown. Those side effects may include:

  • Loose teeth
  • Numbness and tingling around the mouth, hands, fingertips, or feet
  • Pain or burning in the throat, mouth or jaw or swelling or numbness in the mouth or jaw
  • Unusual weight gain or loss
  • Red skin lesions
  • Shortness of breath
  • Sores, ulcers, or white spots on the lips or tongue or inside the mouth
  • Tremors or convulsions
  • Tiredness or weakness or difficulty moving
  • Blistering or peeling skin
  • Bloating or swelling of the face, arms, hands, lower legs, or feet
  • Chest pain
  • Confusion
  • Cough
  • Heavy jaw feeling
  • Hives or welts
  • Irregular heartbeats
  • Itching

Conditions That May Be Exacerbated by the Alendronate Sodium

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Because of the way this particular medication affects the body, a number of pre-existing conditions can be negatively impacted by use of the drug. Some conditions that could create issues for the patient are:

Stomach Ulcers: Patients who have existing stomach problems such as ulcers and indigestion may need to be monitored if prescribed this drug as stomach pain, heartburn and ulcers are among side effects of this medication.

Existing Eye Inflammation: Some patients have reported experiencing dry, red, or itchy eyes when using alendronate sodium. Therefore, to avoid irritating existing eye problems, be sure to alert your doctor.
Jaw Problems: Because of the slight risk of bone loss in the jaw, inform your doctor of any pre-existing jaw conditions or if you’ve had surgery before beginning treatment and monitor healing after any dental procedures.

Impaired Kidney Function: Because the kidneys are required to process alendronate in order to remove it from the body, those with impaired kidney function may need to examine altered dosing or take extra monitoring measures.


Given its ability to slow bone loss and prevent fractures, alendronate sodium offers important and effective treatment for those suffering with osteoporosis or Paget’s disease. In addition, its potential to prevent damaging or risky bone loss can also offer a beneficial solution, especially for those using medications which may cause undesirable bone loss.

While the most common side effects rarely require medical intervention, it’s wise to be aware of side effects that could indicate a serious or allergic reaction. If such side effects occur, be sure to consult your doctor.

It’s also important to alert your physician to any pre-existing conditions that could have an impact on the seriousness of side effects caused by alendromate sodium.

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