Alendronate
Also called: Fosamax, Binosto, alendronic acid
What it means
Alendronate is a bisphosphonate pill (brand names Fosamax, Binosto) used to treat osteoporosis. It slows down bone breakdown so bone density can stabilize or improve over time.
Alendronate is one of the most studied osteoporosis drugs, and trials show it lowers the risk of spine and hip fractures in people with osteoporosis.
Alendronate belongs to a drug class called bisphosphonates, along with risedronate and zoledronic acid. It attaches to bone mineral and gets taken up by osteoclasts, the cells that break down old bone. Once inside, it interferes with their activity and encourages them to die off, which slows the overall pace of bone remodeling.
By slowing resorption, alendronate allows bone-building to catch up, which over time can increase bone density and reduce fracture risk at the spine and hip. It's inexpensive and has a long track record, with decades of safety and effectiveness data from large clinical trials in postmenopausal women and others with osteoporosis.
Like any medication, it has tradeoffs. Oral forms can irritate the esophagus or stomach, so it's usually taken with water on an empty stomach while staying upright. Rare but serious risks, like osteonecrosis of the jaw and atypical femoral fracture, are linked mostly to long-term use. Because alendronate stays in bone for years, doctors sometimes discuss a 'drug holiday' after several years of use — this is a decision to make together with your prescriber, not on your own.
How sure is this?
Graded Strong Clinical Evidence: Supported by multiple well-designed clinical studies in humans. Read each study with its grade in mind. One study is a piece of the picture, not the whole of it.
This well-studied pill slows bone breakdown and has been shown to lower spine and hip fracture risk.
Where this leads
WordCurious how alendronate fits into the bigger picture? See how this whole class of drugs helps bone-building catch up.
Where the Academy teaches it
This page is the short version. The lessons teach it in full, with the context around it and a quiz to lock it in.
Related words
Bisphosphonates are osteoporosis medications — like alendronate, risedronate, and zoledronic acid — that slow down…
Risedronate is an oral bisphosphonate medication (sold as Actonel or Atelvia) used to treat osteoporosis. It slows…
Zoledronic acid is a bisphosphonate drug given as a once-yearly IV infusion to slow bone breakdown and reduce…
A drug holiday is a temporary, prescriber-guided pause from a bisphosphonate medication after several years of use,…
Osteonecrosis of the jaw (ONJ) is a rare condition where part of the jawbone loses blood supply and fails to heal,…
An atypical femoral fracture is an uncommon break in the shaft of the thigh bone that looks and behaves differently…
Education only, not medical advice. Decisions about tests, medications and treatment belong with your own doctor. OsteoStrong does not diagnose, treat or cure any disease.
