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Alendronate Sodium/Cholecalciferol, Oral a-LEN-droh-nate SOH-dee-um KOL-e-kal-SIF-er- ol

What are other names for this medicine?

Type of medicine: bisphosphonate (reduces bone loss)

Generic and brand names: alendronate sodium and cholecalciferol, oral; Fosamax Plus D

What is this medicine used for?

This medicine is used to treat osteoporosis (bone loss) in men and postmenopausal women (those who have stopped having monthly periods). It is a combination of 2 medicines, alendronate and a type of vitamin D. It should not be should to treat vitamin D deficiency.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

  • an allergic reaction to any medicine
  • cancer such as leukemia or lymphoma
  • hypocalcemia (low calcium levels in your blood)
  • kidney disease
  • problems or pain when swallowing
  • sarcoidosis
  • ulcers or diseases of the stomach or esophagus.

Tell your healthcare provider if you are not able to sit or stand upright for at least 30 minutes after taking this medicine.

Tell your provider if you have any dental problems, or if you are scheduled for dental surgery. Also tell your healthcare provider the date of your last dental exam. You may be at risk of a disease called osteonecrosis of the jaw if you have any dental problems or dental surgery while taking this medicine.

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant while taking this medicine and after you stop taking this medicine. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I take it?

Read the Medication Guide that comes in the medicine package when you start taking this medicine and each time you get a refill.

Check the label on the medicine for directions about your specific dose. Take this medicine exactly as your healthcare provider prescribes. Do not take more or less or take it longer than prescribed.

Take the medicine in the morning, before the first food, beverage, or medicines of the day. Do not take this medicine with, or soon after you take other medicines eat, or drink beverages other than water. It will make this medicine less effective.

Take it with a full glass (8 ounces) of plain water (not mineral water, coffee, tea, or orange juice) while you are standing or sitting upright. If you have the tablet, swallow it whole. Do not break, chew, or let the tablet dissolve in your mouth.

Do not take this medicine at bedtime. Do NOT lie down for at least 30 minutes after taking this medicine. This will keep it from irritating your mouth and throat.

Wait at least 30 minutes after taking this medicine before eating or drinking. ALL foods and drinks (except plain water) can make this medicine less effective. Talk with your healthcare provider about this.

Take calcium and vitamin D supplements, antacids, or any other medicine at least 30 minutes after this medicine.

Follow your healthcare provider's instructions about exercise, diet, and taking vitamin supplements such as calcium and vitamin D.

What if I miss a dose?

If you miss a once-daily morning dose, do not take it later in the day. Skip the missed dose and take the next scheduled dose as directed. If you miss a once-weekly dose, take 1 tablet the next day. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: nausea, vomiting, heartburn, stomach pain, diarrhea, muscle cramps or stiffness, numbness, tingling, seizures, irritability, unusual thoughts or behavior, coughing blood, black tarry stools.

What should I watch out for?

This medicine may increase your risk for a rare, but severe thigh bone fracture. Contact your healthcare provider right away if you have any new or unusual thigh or hip pain. Talk with your healthcare provider about this.

You may need a bone density test before you start taking this medicine. Your healthcare provider may want to test you again after 6 to 12 months to see how this medicine affects you.

You may need blood tests regularly while you are taking this medicine. Keep all appointments for these tests.

This medicine may increase severe muscle, joint, or bone pain or may cause pain to occur more often. The increased pain may be temporary and may stop during treatment. The pain may occur when you first start taking this medicine or several months later. If the pain continues or gets worse, contact your healthcare provider.

This medicine may cause a rare, but serious disease called osteonecrosis of the jaw. You may be at an increased risk for this problem if you have any dental problems or dental surgery, have cancer, anemia, or blood clotting problems, or you are receiving chemotherapy or corticosteroids (such as prednisone). Talk with your healthcare provider about this. You should brush your teeth and clean your mouth properly while taking this medicine. If you have any jaw pain, swelling, numbness, or loose teeth, contact your healthcare provider right away.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are taking this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (report these to your healthcare provider right away): Difficulty or pain on swallowing, new or worsening heartburn, severe nausea or vomiting; chest pain or pain under your ribs or in your back; new or unusual pain in your thigh or hip; black or bloody bowel movements; jaw pain, swelling or numbness; severe bone, joint, or muscle pain; skin redness, blistering, or peeling; diarrhea that continues or gets worse; eye pain or redness.

Other: Mild muscle pain, weakness, mild nausea, constipation, diarrhea, gas, headache, upset stomach; runny or stuffy nose, fever, chills.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, and natural remedies may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

  • antacids that contain aluminum or magnesium such as Maalox or Mylanta or magnesium supplements (follow instructions about how long to wait after taking this medicine)
  • antiseizure medicines such as phenytoin (Dilantin, Phenytek) and phenobarbital (Luminal)
  • cholesterol-lowering medicines such as cholestyramine (Questran), and colestipol (Colestid)
  • aspirin or other salicylates
  • calcium supplements and vitamin D (follow instructions about how long to wait after taking this medicine)
  • cimetidine (Tagamet)
  • iron supplements and iron-containing products (follow instructions about how long to wait after taking this medicine)
  • nonsteroidal anti-inflammatory drugs (NSAIDs) such as diclofenac (Voltaren, Cataflam), ibuprofen (Motrin, Motrin IB, Advil), indomethacin (Indocin), ketoprofen, ketorolac (Toradol), nabumetone (Relafen), naproxen (Naprosyn, Anaprox, Aleve, Naprelan), oxaprozin (Daypro), piroxicam (Feldene), and sulindac (Clinoril)
  • mineral oil
  • olestra (Olean)
  • orlistat (alli, Xenical)
  • phosphate supplements
  • thiazide diuretics (water pills) such as chlorothiazide (Diuril) and hydrochlorothiazide (Microzide)

If you take any other medicines, make sure that you know how long to wait before taking them after you have taken this medicine.

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.


This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.


Developed by RelayHealth.
Medication Advisor 2012.1 published by RelayHealth.
Last modified: 2011-02-18
Last reviewed: 2010-11-04
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2012 RelayHealth and/or its affiliates. All rights reserved.
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