Alendronate/cholecalciferol (By mouth)


Alendronate Sodium (a-LEN-droe-nate SOE-dee-um), Cholecalciferol (koe-le-kal-SIF-er-ol)

Treats or prevents osteoporosis (weak bones).

Brand Name(s)

Fosamax Plus D

When This Medicine Should Not Be Used

How to Use This Medicine


  • Take your medicine as directed.
  • Follow your doctor's instructions if you need to take calcium and vitamin D supplements.
  • This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
  • If any of this medicine stays in your esophagus, it may cause serious damage. To lower the risk of this problem, use this medicine exactly as directed.
  • Take this medicine as soon as you get out of bed in the morning, before you eat or drink anything (except water). Swallow the tablet whole with a large glass (6 to 8 ounces) of plain water only (not mineral water, coffee, tea, soda, juice, or any other liquid). Do not chew or suck on the tablet.
  • Wait at least 30 minutes after you take this medicine before you eat or drink anything or take any other medicine. This will help your body absorb the medicine.
  • Take this medicine while you are sitting or standing. Do not take it while you are in bed or at bedtime.
  • Do not lie down for at least 30 minutes after you the medicine, and do not lie down until after you have eaten some food.

If a dose is missed:

  • If you miss a dose or forget to take your medicine, take it the next morning after you remember. Do not take 2 tablets in one day. Return to your regular schedule the following week.

How to Store and Dispose of This Medicine

  • Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep your medicine in the original package until you are ready to use it. Keep the package and tablets dry.
  • Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
  • Keep all medicine out of the reach of children. Never share your medicine with anyone.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • Make sure your doctor knows if you are also using cimetidine (Tagamet®), mineral oil, olestra (Olean®), orlistat (Xenical®), medicine to lower your cholesterol (such as cholestyramine, colestipol, Colestid®, Questran®), medicine to treat seizures (such as carbamazepine, phenobarbital, phenytoin, Dilantin®), or a diuretic (water pill, such as hydrochlorothiazide).
  • Make sure your doctor knows if you are using aspirin or products that contain aspirin, or any type of NSAID pain or arthritis medicine (such as diclofenac, ibuprofen, naproxen, Advil®, Aleve®, Celebrex®, Voltaren®).
  • Make sure your doctor knows if you are also using medicine or receiving treatments that weaken your immune system, such as cancer treatment, radiation treatment, or steroids (such as dexamethasone, hydrocortisone, methylprednisolone, prednisolone, prednisone, Medrol®).
  • Wait at least 30 minutes after you take alendronate before you take any other oral medicine, including aluminum, magnesium, iron, or calcium supplements and antacids (such as Maalox®, Mylanta®, Tums®).

Warnings While Using This Medicine

  • Make sure your doctor knows if you are pregnant or breastfeeding, or if you have kidney disease, stomach ulcers, heartburn, or any other stomach or bowel problems. Tell your doctor if you have trouble absorbing minerals in your stomach (malabsorption syndrome) or if you have blood or bone marrow problems (such as leukemia, lymphoma, sarcoidosis). Also tell your doctor if or smoke or drink alcohol.
  • This medicine may harm your throat and esophagus. Stop taking this medicine and call your doctor right away if you have heartburn (either new or worse than usual), pain when swallowing, pain in the center of your chest, trouble swallowing, or a feeling that food gets stuck on the way to your stomach.
  • Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine could cause jaw problems, especially if you have a tooth pulled or have other dental work. Tell your doctor or dentist if you have pain, swelling, or other problems in your mouth or jaw. Make sure your doctor knows about dental problems that you already have and if you wear dentures. Also tell your doctor if you have cancer, anemia, or blood clotting problems, because you could be more likely to develop jaw problems.
  • This medicine could lower the amount of calcium in your blood. Call your doctor right away if you develop any signs of low calcium levels, such as muscle spasms or twitching, or numbness or tingling in your fingers, toes, or lips.
  • This medicine may increase your risk of breaking a thigh bone. This may be more common if you use it for a long time. Check with your doctor right away if you have a dull or aching pain in the thighs, groin, or hips.
  • Your doctor will check your progress and the effects of this medicine at regular visits. Keep all appointments.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
  • Chest pain, heartburn, or burning feeling in your throat
  • Difficult or painful swallowing
  • Heavy feeling in the jaw, loose teeth, or other teeth problems
  • Muscle spasms, twitching, tingling, numbness
  • Pain, swelling, or numbness in the mouth or jaw
  • Severe bone, joint, or muscle pain
  • Unusual or severe stomach pain
  • Unusual pain in your thigh, groin, or hip
  • Urinating more or more often than normal, increased thirst

If you notice these less serious side effects, talk with your doctor:

  • Mild stomach pain

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Version Info

  • Last reviewed on 8/4/2014

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