Alendronic acid

Alendronic acid is suitable for most adults and it's sometimes prescribed for children. Always check before taking it.

Alendronic acid is not suitable for everyone. For example, check it's OK with your doctor if you have digestive problems, kidney problems or cancer.

Alendronic acid comes as standard tablets, tablets that dissolve in water (soluble), and as a liquid. You usually take it once a week.

Side effects of alendronic acid include constipation and feeling dizzy. More serious side effects can happen in rare cases.

Alendronic acid is not recommended during pregnancy.

It can cause problems to take alendronic acid with some other medicines, such as some laxatives, steroid tablets and ibuprofen.

Most adults can take alendronic acid. Children who have osteoporosis can sometimes take it if it's been prescribed for them by a specialist doctor.

Alendronic acid is not suitable for some people. Check with your doctor or pharmacist before starting to take it if you:

• have ever had an allergic reaction to alendronic acid or any other medicine
• have problems digesting food, swallowing or other problems with your food pipe (oesophagus)
• have taken alendronic acid before but it made you feel dizzy
• are unable to stand or sit upright for at least 30 minutes after taking it
• have low calcium levels in your blood – alendronic acid sometimes causes low blood calcium, so your calcium levels could become even lower
• have kidney problems
• have cancer, or are having chemotherapy or radiotherapy
• have problems with your teeth, or are waiting for dental treatment such as having a tooth out
• smoke, or used to smoke – this may increase your risk of dental problems
• are pregnant, trying to get pregnant or breastfeeding

Always follow the instructions that come with the alendronic acid, or the advice from your doctor.

The usual dose of alendronic acid for adults is 70mg taken once a week.

You'll usually take it as a standard tablet, a liquid that you drink or a tablet that dissolves in water (soluble).

Alendronic acid is also available as a 10mg tablet you take once a day.

How to take it

Whether you take alendronic acid daily or weekly, you need to take it at the same time of day. If you take it weekly, choose a day that suits your routine.

The best time of day to take your medicine is usually 30 minutes before you have breakfast. Take it on an empty stomach, before you have anything to eat or drink (other than plain tap water) and before you take any other medicines that you swallow.

Alendronic acid works best on an empty stomach because your body can absorb it properly.

Do not take alendronic acid with still or sparkling mineral water, tea, coffee, juice or milk. These drinks can affect the way the medicine works by reducing how much is absorbed. Take your medicine with tap water.

If it's not safe to drink your tap water for any reason, you can boil it and let it cool before you drink it.

It's also important to take alendronic acid while you're sitting up or standing. Try to stay upright for 30 minutes after taking your medicine – you can be sitting, standing or walking. Do not take alendronic acid at bedtime.

These common side effects of alendronic acid happen in more than 1 in 100 people. There are things you can do to help cope with them:

Try to stay upright for at least 30 minutes after taking alendronic acid. It might also help to eat smaller meals more often. You could also try eating and drinking more slowly, and increase your level of exercise if you can.

Make sure you follow the instructions for taking alendronic acid carefully.

If the symptoms do not go away or get worse, contact your doctor straight away.

Eat more high-fibre foods such as fresh fruit, vegetables and cereals. Try to drink several glasses of water or squash every day. If you can, try to increase your level of exercise. If this does not help, talk to your pharmacist or doctor.

Drink plenty of water to avoid dehydration. Speak to a pharmacist if you have signs of dehydration, such as peeing less than usual or having dark, strong-smelling pee.

Do not take any medicines to treat diarrhoea without speaking to a pharmacist or doctor.

If you take the combined contraceptive pill or the progestogen-only pill and you have severe, watery diarrhoea or any diarrhoea that lasts for more than 24 hours, your contraception may not protect you from pregnancy. Check the pill packet for advice.

Stop what you're doing, and sit or lie down until you feel better. If you've just taken alendronic acid try to avoid lying down for 30 minutes.

Do not drive, cycle or use tools or machinery until your dizziness has gone.

It's best not to drink alcohol until you see how the medicine affects you.

Make sure you rest and drink plenty of fluids. Try not to drink too much alcohol.

Ask your pharmacist to recommend a painkiller, and talk to your doctor if the pain does not go away or is severe.

Try to rest. Avoid standing for long periods of time if you have swollen legs, and put your feet on a stool or cushion to raise your legs when you're sitting.

Talk to your doctor if the swelling is severe or does not go away.

Do not drive, cycle or use tools or machinery if you're feeling tired. Try not to drink any alcohol, as this will make you feel more tired.

Thinning hair or mild hair loss in itself can be stressful but it's not usually a sign of anything to worry about. Talk to your pharmacist or doctor if you're concerned.

Speak to a doctor or pharmacist if the advice on how to cope does not help and these side effects bother you or do not go away.

Alendronic acid is not recommended during pregnancy. This is because there has not been enough research into its safety.

It's usually OK to take alendronic acid while breastfeeding. Talk to your doctor or pharmacist first, and they will help you to decide.

It's not known how much alendronic acid gets into breast milk, but it's likely to be very low levels. Not a lot of it will pass through to your baby, so it's unlikely to cause them any side effects.

It's very rare for breastfed babies to have side effects from medicines you're taking. But it's important to keep monitoring your baby if you're taking any medicine while breastfeeding.

Contact your healthcare professional or call 111 as soon as possible if you notice that your baby is:

• not feeding as well as usual
• being irritable
• being sick (vomiting) or has diarrhoea
• constipated

If your baby has any symptoms that are not listed, or if you're worried about them, you can also call 111 or contact any healthcare professional.

Carry on taking the medicine, and keep breastfeeding as usual until you've got advice about your baby's symptoms.

Some medicines affect the way alendronic acid works.

If you need to take other medicines by mouth (orally), do not take them at the same time as your alendronic acid. This is because other medicines can react with alendronic acid and stop it working properly.

If you do need to take another medicine by mouth, wait for at least 30 minutes.

Tell your doctor if you're taking any other medicines, including:

• antacids to relieve indigestion or heartburn
• laxatives containing magnesium
• cancer medicines such as bevacizumab or thalidomide
• steroids such as prednisolone or dexamethasone – these may increase the risk of damage to your jawbone
• non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, which can increase the risk of irritating your food pipe, stomach or gut (taking low-dose aspirin is OK)
• antibiotics such as gentamicin, amikacin or tobramycin – these can lower the calcium in your blood
• deferasirox, a medicine used to remove excess iron from the body – this may increase the risk of bleeding from your gut

These are not all the medicines that may cause problems if you take them with alendronic acid. For a full list, see the leaflet inside your medicine packet.

Also tell your doctor if you are having chemotherapy.