It is important that your doctor check your progress at regular visits, to allow for dosage adjustments and to help reduce side effects. The following information may affect your usage of alendronate, so be sure to tell your doctor:

• If you are pregnant or breastfeeding
• If you are planning to be pregnant or breastfeeding
• If you are following a special diet
• If you are taking aspirin, products that contain aspirin, or other nonsteroidal anti-inflammatory drugs (NSAIDs)
• If you are taking antacids (calcium) or ranitidine

Alendronate may make some medical conditions worse. Tell your doctor if you have any medical problems, especially:

• Stomach, intestinal, or esophageal problems
• Kidney problems
• Low level of blood calcium or vitamin D deficiency

Take alendronate in the morning on an empty stomach. Take with a full glass of plain water, and wait at least 30 minutes before consuming any food, beverage, or other medicines. Food and beverages other than plain water will decrease the amount of alendronate absorbed by the body. Medicines such as antacids or calcium or vitamin supplements will also decrease absorption. Waiting at least 30 minutes allows for more of the drug to be absorbed.

Do not lie down for 30 minutes after taking this drug. Staying upright will help the alendronate reach your stomach faster, and will help prevent irritation in your throat.

You may be advised to increase the amount of calcium and vitamin D in your diet. Both of these nutrients are important for bone health. You can get these nutrients through foods, but your doctor may also recommend a supplement.

Sources of calcium include:

• Milk, yogurt, cheese, and other dairy products
• Calcium-fortified juices and breakfast cereals
• Sardines and salmon with bones
• Leafy green vegetables, such as spinach, kale, and turnip greens

Sources of vitamin D include:

• Fortified milk
• Fish oil
• Sunshine; your body can make vitamin D with the sunlight absorbed through your skin