ALENDRONATE slows calcium loss from bones. It helps to make normal healthy bone and to slow bone loss in people with Paget's disease and osteoporosis. It may be used in others at risk for bone loss.

They need to know if you have any of these conditions:

• dental disease
• esophagus, stomach, or intestine problems, like acid reflux or GERD
• kidney disease
• low blood calcium
• low vitamin D
• problems sitting or standing
• trouble swallowing
• an unusual or allergic reaction to alendronate, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

You must take this medicine exactly as directed or you will lower the amount of the medicine you absorb into your body or you may cause yourself harm. Take this medicine by mouth first thing in the morning, after you are up for the day. Do not eat or drink anything before you take your medicine. Swallow the tablet with a full glass (6 to 8 fluid ounces) of plain water. Do not take this medicine with any other drink. Do not chew or crush the tablet. After taking this medicine, do not eat breakfast, drink, or take any medicines or vitamins for at least 30 minutes. Sit or stand up for at least 30 minutes after you take this medicine; do not lie down. Do not take your medicine more often than directed.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

If you miss a dose, take the dose on the morning after you remember. Then take your next dose on your regular day of the week. Never take 2 doses on the same day. Do not take double or extra doses.

• aluminum hydroxide
• antacids
• aspirin
• calcium supplements
• drugs for inflammation like ibuprofen, naproxen, and others
• iron supplements
• magnesium supplements
• vitamins with minerals

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

Visit your doctor or health care professional for regular checks ups. It may be some time before you see benefit from this medicine. Do not stop taking your medicine except on your doctor's advice. Your doctor or health care professional may order blood tests and other tests to see how you are doing.

You should make sure you get enough calcium and vitamin D while you are taking this medicine, unless your doctor tells you not to. Discuss the foods you eat and the vitamins you take with your health care professional.

If you get a rash, limit your time in the sun and in tanning beds. Sunlight may cause the rash to get worse. Call your doctor.

Some people who take this medicine have severe bone, joint, and/or muscle pain. Tell your doctor if you have pain that does not go away or that gets worse.

Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
• black or tarry stools
• changes in vision
• chest pain
• heartburn or stomach pain
• jaw pain, especially after dental work
• pain or trouble when swallowing
• redness, blistering, peeling or loosening of the skin, including inside the mouth

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• bone, muscle or joint pain
• changes in taste
• diarrhea or constipation
• eye pain or itching
• headache
• nausea or vomiting
• stomach gas or fullness

This list may not describe all possible side effects.

Keep out of the reach of children.

Store at room temperature of 15 and 30 degrees C (59 and 86 degrees F). Throw away any unused medicine after the expiration date.