Alendronate is approved for the prevention and treatment of osteoporosis in postmenopausal women and for the treatment of osteoporosis in men. It also is approved for the treatment of glucocorticoid-induced osteoporosis in men and women as a result of long-term use of steroid medicines (examples are prednisone and cortisone). Alendronate reduces bone loss, increases bone density and reduces the risk of spine and non-spine fractures including hip fractures.
For prevention, alendronate is taken daily as a 5 mg tablet or weekly as a 35 mg tablet. For treatment, it is taken daily as a 10 mg tablet, weekly as a 70 mg tablet (with or without vitamin D3) or weekly as a 70 mg effervescent tablet. The weekly dose with vitamin D3 contains either 2,800 IU or 5,600 IU of vitamin D3.
The alendronate tablet must be taken first thing in the morning after waking up and on an empty stomach. It is swallowed whole by itself (no other pills) with 6 to 8 ounces of plain water (no other liquid), at least 30 minutes before having anything to eat or drink. The Binosto effervescent tablet must be dissolved in 4 ounces of plain water (no other liquid). Patients must remain upright (sitting, standing or walking) during this 30-minute period. This careful dosing is necessary to ensure that the alendronate is absorbed, and to minimize the risk of irritation of the esophagus.
Alendronate with either 2,800 IU or 5,600 IU of vitamin D3 provides another option for a source of vitamin D. Weekly alendronate with 2,800 IU of vitamin D3 is the equivalent of taking 400 IU daily, while weekly alendronate with 5,600 IU of vitamin D3 is the equivalent of taking 800 IU daily. Vitamin D3 is also called cholecalciferol.