Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes Fosamax (Alendronate). If you are concerned about side effects, discuss the risks and benefits of Fosamax (Alendronate) with your doctor.

The following side effects have been reported by at least 1% of people taking Fosamax (Alendronate). Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• abdominal pain
• bloating
• changed sense of taste
• Constipation
• Diarrhea
• dizziness
• gas
• hair loss
• headache
• heartburn
• mild skin rash or redness
• nausea
• pain in bones, muscles, or joints
• rash that is made worse by sunlight
• spinning sensation
• vomiting

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• persistent ear pain
• severe joint, bone, or muscle pain
• symptoms of low calcium levels such as muscle spasms, and prickling or tingling sensations around the mouth or in the hands or feet
• vision changes or eye pain

Stop taking the medication and seek immediate medical attention if any of the following occur:

• delayed healing and infection of mouth and jaw (usually after tooth extraction)
• new or unusual pain in the hip or thigh
• signs of a serious allergic reaction (e.g., swelling of face or throat, Hives, or difficulty breathing)
• signs of a severe skin reaction (e.g., high Fever; rash; sores; painful blisters on the skin, mouth, or eyes; or skin peeling off)
• signs of damage to the esophagus (e.g., pain in the esophagus [throat area] or behind the breastbone, chest pain, difficulty swallowing, pain when swallowing, or new or worsening heartburn)
• symptoms of a stomach or intestinal ulcer (e.g., nausea, vomiting, abdominal pain, loss of weight or appetite, black or bloody stools, or vomiting blood)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Fosamax (Alendronate).

70 mg
Each white, oval, uncoated tablet with an outline of a bone image on one side and "31" on the other contains 91.37 mg of Fosamax (Alendronate) monosodium salt trihydrate, which is equivalent to 70 mg of Fosamax (Alendronate). Nonmedicinal ingredients: anhydrous lactose, croscarmellose sodium, magnesium stearate, and microcrystalline cellulose.

Do not take Fosamax (Alendronate) if you:

• are allergic to Fosamax (Alendronate) or any ingredients of the medication
• cannot stand or sit upright for at least 30 minutes
• have an abnormality of the esophagus (passage leading from throat to stomach) that delays the emptying of the esophagus into the stomach
• have low blood calcium
• have severely reduced kidney function

There may be an interaction between Fosamax (Alendronate) and any of the following:

• aminoglycoside antibiotics (e.g., Amikacin, gentamicin, tobramycin)
• antacids (e.g., aluminum hydroxide, calcium carbonate, magnesium hydroxide)
• Asa and ASA-containing products (when Fosamax (Alendronate) is taken in doses greater than 10 mg daily) - note that this does not apply to the 70 mg weekly dose
• calcium supplements (wait at least 30 minutes after taking Fosamax (Alendronate) to take calcium supplements)
• Deferasirox
• H2 antagonists (e.g., Famotidine, Ranitidine)
• non-steroidal anti-inflammatory medications (NSAIDs; e.g., Diclofenac, Ibuprofen, Naproxen)
• proton pump inhibitors (e.g., Lansoprazole, Omeprazole)
• systemic angiogenesis inhibitors (e.g., Axitinib, Bevacizumab, Lenalidomide, Pazopanib, Regorafenib, Vandetanib)
• supplements containing minerals such as aluminum, calcium, iron, magnesium and phosphate
• other medications given by mouth (wait at least 30 minutes after taking Fosamax (Alendronate) to take any other medication by mouth)

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Fosamax (Alendronate). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Fosamax (Alendronate).

Atypical femur fracture: There is evidence that long term use of this class of medication may contribute to a type of rare fracture of the long bone in the thigh (femur) without any form of trauma.

If you experience new or unusual pain in the groin, hip, or thigh area, contact your doctor as soon as possible.

Bone, joint, and muscle problems: Rarely, people taking Fosamax (Alendronate) experience severe bone, joint, or muscle pain. This is usually reversed when the medication is stopped.

Calcium and vitamin D: Calcium and vitamin D are important contributors to bone growth and strength. It may be necessary to take calcium or vitamin D supplements to get the best effect from Fosamax (Alendronate) if you are not getting enough from your diet. Your doctor may test you for low calcium levels or vitamin D deficiency before you start taking Fosamax (Alendronate).

Effects on the esophagus: Fosamax (Alendronate) may irritate the lining of the esophagus (the passage from the throat to the stomach). Esophagitis, ulcers, and erosions have been reported by people who take Fosamax (Alendronate). In some cases, these effects have been severe and have required hospitalization. Contact your doctor at once if you suddenly experience problems swallowing, find it painful to swallow, develop pain behind the sternum (breastbone), or have new or worsening heartburn.

To ease the passage of the medication to the stomach and thus reduce the potential for irritation of the esophagus, swallow Fosamax (Alendronate) with a full glass of plain water upon arising for the day. Do not lie down until 30 minutes have passed and you have eaten your first food of the day. Do not chew or suck on the tablet, as this may lead to ulcers in the mouth or throat. Do not take Fosamax (Alendronate) at bedtime or before getting up for the day.

Effects on the stomach and intestines: Rarely, people taking Fosamax (Alendronate) have developed ulcers of the stomach or intestines. If you suffer from stomach problems, such as ulcers and severe indigestion, discuss with your doctor how Fosamax (Alendronate) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Fosamax (Alendronate), and whether any special monitoring is needed.

Get immediate medical attention if you have symptoms of a stomach or intestinal ulcer, such as nausea, vomiting, abdominal pain, loss of weight or appetite, black or bloody stools, or vomiting blood.

Inflammation of the eye: Conditions of eye inflammation have been reported by people using Fosamax (Alendronate). If you experience changes to your vision, red eyes, or eye pain, contact your doctor as soon as possible.

Jaw problems: Rarely, Fosamax (Alendronate) may cause severe jaw problems associated with delayed healing and infection, especially in people with cancer or after tooth extractions. If you experience any pain in the jaw, especially after having a tooth removed, contact your doctor immediately.

Kidney function: Fosamax (Alendronate) is removed from the body by the kidneys. If you have reduced kidney function or Kidney Disease, discuss with your doctor how Fosamax (Alendronate) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Fosamax (Alendronate), and whether any special monitoring is needed.

Pregnancy: Fosamax (Alendronate) should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Fosamax (Alendronate), contact your doctor immediately.

Breast-feeding: It is not known if Fosamax (Alendronate) passes into breast milk. If you are a breast-feeding mother and are taking Fosamax (Alendronate), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children and adolescents: The safety and effectiveness of using Fosamax (Alendronate) have not been established for children under 18 years of age.