Alendronate is the Generic version of Fosamax. It is taken weekly on an empty stomach followed by at least 8 ounces of water. No other food or drink is allowed for at least half an hour. Alendronate is one of the Bisphosphonates and has all of the potential benefits and risks of that class.
About 20 different companies make Alendronate competing fiercely in price. Alendronate is the cheapest Osteoporosis medication much of the time. Many insurance plans require that you try it first unless you already have heartburn, GERD, or ulcers. Iowa Medicaid and a few others may require that you try it first, even if you already have heartburn, GERD, or ulcers.
Heartburn, GERD, ulcers, metallic taste, and other digestive issues seem to be more common in Alendronate. While all Oral Bisphosphonates can cause these problems, the thinner and less effective coatings on some Alendronate pills make it more likely. This is the downside of fierce price competition among generic manufacturers.
Jay Ginther, MD
2008 / Revised March 2011