Alendronic acid strengthens bone and reduces fracture risk in osteoporosis. It has the most demanding set of instructions of any common tablet — and following them exactly is not fussiness, it is the difference between it working and it damaging your gullet.
Do not chew, crush or suck the tablet. If it lodges in the gullet it can cause ulceration.
Most people take it once weekly on the same day — choose a day that suits the routine, since the 30 minutes upright is the hard part.
If you miss a weekly dose, take it the following morning and then return to your usual day. Do not take two in one day.
Alendronic acid works best with adequate calcium and vitamin D, and most people are prescribed or advised to take supplements. Take those at a different time of day — calcium blocks absorption of the alendronic acid entirely.
Have a dental check before starting if you can, and keep up routine dental care. Osteonecrosis of the jaw is rare but is associated with bisphosphonates, particularly after dental extractions. Tell your dentist you take it before any procedure, and report jaw pain, swelling, numbness or a non-healing socket.
Indigestion, heartburn, difficulty swallowing, stomach pain, muscle and joint aches are the common ones.
Stop and seek advice for painful swallowing, new or worsening heartburn, or chest pain on swallowing — these can indicate gullet irritation.
Report new thigh, hip or groin pain, which very rarely can indicate an unusual stress fracture.
It is not suitable if you cannot sit or stand upright for 30 minutes, if you have certain gullet problems, or if your calcium is low.
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