Alendronate

Alendronate is a member of the bisphosphonate family of drugs used to treat/prevent osteoporosis. It is also used to treat some bone diseases and some cases of cancer that have spread to bones.

Summary of Interactions with Vitamins, Herbs, and Foods
(for details about the summarized interactions, read the full article)

Check: Other—Before taking any of these supplements or eating any of these foods with your medication, read this article in full for details.	Calcium Magnesium
Depletion or interference	None known
Side effect reduction/prevention	None known
Supportive interaction	None known
Reduced drug absorption/bioavailability	None known
Adverse interaction	None known

Interactions with Dietary Supplements

Calcium
Calcium supplements may interfere with alendronate absorption.¹ However, one researcher suggested that addition of large amounts of supplemental calcium to alendronate therapy in patients with bone metastases (with evidence of osteomalacia) related to prostate cancer might improve the clinical outcome.² Moreover, both calcium and alendronate are commonly used in the treatment of osteoporosis in the same people. To prevent potential interactions, alendronate should be taken two hours before or after calcium supplements.

Magnesium
Absorption of tiludronate, a drug related to alendronate, is reduced when taken with magnesium and/or aluminum-containing antacids.³ This interaction has not yet been reported with alendronate. Until more is known, alendronate should be taken two hours before or after magnesium and/or aluminum-containing antacids.

Interactions with Foods and Other Compounds

Food
Food, coffee, and orange juice significantly reduce absorption of alendronate.⁴

Alendronate should be taken with a large glass of plain water, upon arising in the morning, and 30 minutes or more before any food, beverages, supplements, or other medications.⁵ People taking alendronate should remain upright (do not lie down) for 30 minutes after taking the drug.⁶

References

1. Threlkeld DS, ed. Hormones, Bisphosphonates. InFacts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Jul 1998, 134r.

2. Adami S. Bisphosphonates in prostate carcinoma. Cancer 1997;80:1674–9.

3. Threlkeld DS, ed. Hormones, Bisphosphonates. InFacts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Jul 1998, 134r.

4. Gertz BJ, Holland SD, Kline WF, et al. Studies of the oral bioavailability of alendronate. Clin Pharmacol Ther 1995;58:288–98.

5. Threlkeld DS, ed. Hormones, Bisphosphonates. InFacts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Jul 1998, 134r.

6. Threlkeld DS, ed. Hormones, Bisphosphonates. InFacts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Jul 1998, 134r.

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The information presented in Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over-the-counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires March 2005.