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Alendronate

Alendronate is a bisphosphonate (bone-strengthening medicine) used to treat and prevent osteoporosis, treat glucocorticoid-induced osteoporosis, and treat Paget's disease of bone, depending on the product.

Brand names BinostoFosamax
Drug classes Bisphosphonate
Rx Forms 2
Dr. Brian Staiger, PharmD, BCPS
Reviewed by Last reviewed Jul 10, 2026 Content updated Oct 2, 2026
🧬 Where this information comes from Click to expand

The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 26 clinical label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →

✓No current FDA shortage listed · checked Oct 5, 2026 🚨Recall on record
Alendronate at a glance The quick version — the full detail is in the Patient Information Guide below.
Dr. Brian Staiger, PharmD, BCPS
The Pharmacist’s Take By · Clinical pharmacist · Written

Alendronate (Fosamax) is a bone-strengthening bisphosphonate that attaches to bone and slows the cells that break it down. It is the usual first choice to treat and prevent osteoporosis and is also used for Paget's disease of bone in some products, on the market since the late 1990s and available generically. Most people tolerate it well, with heartburn or indigestion the usual complaints, but how well it works and how gentle it is on the esophagus (food tube) depend on taking it with plain water, then nothing else for 30 minutes while staying upright. Stop it and get help for trouble or pain swallowing or chest pain behind the breastbone, and report new thigh or groin pain promptly.

Clinical pearls

  • Plain water means exactly that, because mineral water, coffee and orange juice all reduce how much alendronate you absorb.
  • Get enough calcium and vitamin D, but take calcium supplements and antacids at least 30 minutes after alendronate, never alongside it.
  • Tell your dentist you take alendronate, and report jaw pain or slow healing after dental work.
  • The best length of treatment is not established, so your prescriber should regularly reassess whether you still need it.
How we write & review this content — our editorial policy →
How you get itPrescription only
Comes asTablet, Oral solution
Earliest FDA record1995
Companies listing it with the FDA17
FDA label last updatedDec 16, 2025
FDA’s strongest warning (boxed)None on the label

Patient information guide A plain-language walkthrough of Alendronate, written from its FDA label.

What Alendronate is used for

▾

Alendronate is a bisphosphonate used for bone conditions. Uses depend on the product.

  • Treatment of osteoporosis in postmenopausal women (all supported products, including Binosto effervescent tablets and the oral solution).
  • Prevention of osteoporosis in postmenopausal women (Alendronate, Alendronate Sodium and Fosamax tablets).
  • Treatment to increase bone mass in men with osteoporosis (all supported products).
  • Glucocorticoid-induced osteoporosis in men and women with low bone density taking steroid medicine (Alendronate, Alendronate Sodium and Fosamax tablets).
  • Paget's disease of bone in men and women (Alendronate, Alendronate Sodium and Fosamax tablets).

How Alendronate works

▾

Alendronate binds to bone, especially where bone is being broken down. There it reduces the activity of osteoclasts, the cells that resorb (break down) bone.

Bone turnover slows, and bone formation exceeds breakdown at remodeling sites. Over time, bone mass gradually rises. Once built into bone, alendronate is inactive, so the medicine must be taken continuously to keep suppressing osteoclasts.

Alendronate dosage

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Alendronate is taken by mouth, as a tablet, an effervescent tablet (Binosto) or an oral solution. Depending on the product and condition, it is taken once a day or once a week. Your prescriber chooses the schedule.

  • Take it when you get up, at least 30 minutes before food, drink or other medicines.
  • Use plain water only. Coffee, juice, mineral water and food cut absorption sharply.
  • Stay upright for at least 30 minutes and until after your first food.
  • Never take it at bedtime.
  • Follow your product's label for missed doses and ask your pharmacist if unsure.

Dosing details from the FDA-approved label

From the Alendronate prescribing information (“Dosage and Administration”). Doses are set by your prescriber for your product, condition, kidney function and age — never change a dose on your own.

  • Treatment of Osteoporosis in Postmenopausal Women
    • Binosto: one 70 mg effervescent tablet once weekly
    • Fosamax and alendronate sodium tablets: 70 mg (tablet or oral solution) once weekly or 10 mg tablet once daily
    • Binosto: dissolve in 4 ounces room temperature plain water, wait at least 5 minutes after effervescence stops, stir for approximately 10 seconds; take at least 30 minutes before the first food, beverage, or medication of the day. Tablets: swallow whole with 6-8 ounces plain water at least 30 minutes before first food, drink or medication
  • Treatment to Increase Bone Mass in Men With Osteoporosis
    • Binosto: one 70 mg effervescent tablet once weekly
    • Fosamax and alendronate sodium tablets: 70 mg (tablet or oral solution) once weekly or 10 mg tablet once daily
    • Take at least 30 minutes before the first food, beverage, or medication of the day; do not lie down for at least 30 minutes and until after first food of the day
  • Prevention of Osteoporosis in Postmenopausal Women
    • 35 mg tablet once weekly or 5 mg tablet once daily
    • Swallow tablet whole with 6-8 ounces plain water at least 30 minutes before first food, drink or medication of the day
  • Glucocorticoid-Induced Osteoporosis
    • 5 mg tablet once daily
    • 10 mg tablet once daily for postmenopausal women not receiving estrogen
    • Patients treated with glucocorticoids should receive adequate amounts of calcium and vitamin D
  • Paget's Disease of Bone
    • 40 mg once a day for six months
    • Re-treatment may be considered after a six-month post-treatment evaluation period in patients who have relapsed or failed to normalize serum alkaline phosphatase
Read the label’s full dosing text

2 DOSAGE AND ADMINISTRATION 70 mg BINOSTO effervescent tablet once weekly. ( 2.1 , 2.2 ) Instruct patients to: ( 2.3 ) Dissolve one tablet of BINOSTO in approximately half a glass of plain room temperature water (4 oz). Wait at least 5 minutes after the effervescence stops, stir the solution for approximately 10 seconds and consume contents. Swallow solution at least 30 minutes before the first food, beverage, or medication of the day. Avoid lying down for at least 30 minutes after taking BINOSTO and until after the first food of the day. 2.1 Treatment of Osteoporosis in Postmenopausal Women The recommended dosage is one 70 mg effervescent tablet once weekly. 2.2 Treatment to Increase Bone Mass in Men With Osteoporosis The recommended dosage is one 70 mg effervescent tablet once weekly. 2.3 Important Administration Instructions Instruct patients to do the following to assure adequate drug absorption and to decrease the risk of esophageal adverse reactions: Waiting less than 30 minutes, or taking BINOSTO with food, beverages (other than plain water) or other medications will lessen the effect of BINOSTO by decreasing its absorption into the body [see Drug Interactions ( 7.1 )] . Take BINOSTO upon arising for the day and at least 30 minutes before the first food, beverage, or medication of the day. Dissolve the effervescent tablet in 4 ounces room temperature plain water only (not mineral water or flavored water). Wait at least 5 minutes after the effervescence stops and then stir the solution for approximately 10 seconds and ingest. Avoid lying down for at least 30 minutes after taking BINOSTO and until after their first food of the day. Do not take BINOSTO at bedtime or before arising for the day. Failure to follow these instructions may increase the risk of esophageal adverse reactions [see Warnings and Precautions ( 5.1 )] . 2.4 Recommendations for Calcium and Vitamin D Supplementation Instruct patients to take supplemental calcium and vitamin D if dietary intake is inadequate [see Warnings and Precautions ( 5.2 )] . Patients at increased risk for vitamin D insufficiency (e.g., over the age of 70 years, nursing home-bound, or chronically ill) may need vitamin D supplementation. Patients with gastrointestinal malabsorption syndromes may require higher doses of vitamin D supplementation and measurement of 25-hydroxyvitamin D should be considered.

Excerpted — the section continues on the label. Read the full Dosage and Administration section on DailyMed →

Alendronate side effects

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Most side effects involve the stomach and muscles or bones.

Common side effects

  • Abdominal pain
  • Acid regurgitation
  • Heartburn or indigestion
  • Nausea
  • Constipation
  • Diarrhea
  • Bone, muscle or joint pain

When to get medical help

  • Trouble or pain with swallowing, chest pain behind the breastbone, or new or worsening heartburn: stop the medicine and get medical attention. These can be signs of esophagus irritation.
  • Severe bone, joint or muscle pain: call your doctor, as the medicine may need to be stopped.
  • New thigh or groin pain: tell your doctor right away. It can signal an unusual thigh bone fracture.
  • Jaw pain, or slow healing after dental work: tell your doctor and dentist. This can signal osteonecrosis of the jaw (damage to jaw bone).
  • Hives or swelling of the face, lips or throat: get medical help, as these can be allergic reactions.
  • Severe skin reactions, such as blistering or peeling: get medical help.
  • Muscle cramps, numbness or tingling that may signal low calcium: call your doctor.

Alendronate warnings and precautions

▾
  • Esophagus irritation: can cause sores, bleeding, narrowing or a hole. Lying down after a dose or continuing despite symptoms raises the risk.
  • Low calcium: must be corrected before starting. Other mineral problems, such as vitamin D deficiency, should be treated.
  • Severe bone, joint or muscle pain: can start days to months after starting. Stop and call your doctor if it is severe.
  • Osteonecrosis of the jaw: linked to dental procedures, poor oral hygiene and other risk factors. The risk may rise with longer use.
  • Unusual thigh bone fractures: often preceded by dull thigh or groin pain.
  • Duration: the best length of treatment is unknown. People at low fracture risk may consider stopping after 3 to 5 years.

Alendronate interactions

▾

Several things can reduce absorption or add to stomach irritation.

  • Calcium supplements, antacids and products with multivalent cations: they interfere with absorption. Wait at least 30 minutes.
  • Food, coffee, orange juice and mineral water: they greatly reduce absorption.
  • Aspirin products: more upper stomach and esophagus side effects at higher daily alendronate doses.
  • NSAIDs: can irritate the stomach, so use caution together.
  • Levothyroxine: slightly lowered alendronate absorption with Binosto.

Interactions listed in the FDA-approved label

From the Alendronate prescribing information (“Drug Interactions”): what the manufacturer studied or reported to the FDA.

  • Calcium supplements, antacids, or oral medications containing multivalent cations: Co-administration will interfere with absorption of alendronate. Instruct patients to wait at least one-half hour after taking the alendronate before taking any other oral medications.
  • Aspirin: The incidence of upper gastrointestinal adverse events was increased in patients receiving daily doses of alendronate sodium greater than 10 mg with aspirin-containing products. Use caution when co-prescribing aspirin.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs): The label says it may be administered to patients taking NSAIDs; in a 3-year study the incidence of upper gastrointestinal adverse events was similar with alendronate sodium 5 or 10 mg/day and placebo, but NSAID use is associated with gastrointestinal irritation. Use caution during concomitant use.
  • Levothyroxine: The bioavailability of alendronate was slightly decreased when co-administered with levothyroxine in healthy subjects.
Read the label’s full interactions text

7 DRUG INTERACTIONS Calcium supplements, antacids or oral medications containing multivalent cations interfere with absorption of alendronate. ( 7.1 ) Use caution when co-prescribing aspirin/nonsteroidal anti-inflammatory drugs that may worsen gastrointestinal irritation. ( 7.2 , 7.3 ) 7.1 Calcium Supplements/Antacids Co-administration of BINOSTO and calcium, antacids, or oral medications containing multivalent cations will interfere with absorption of BINOSTO. Therefore, instruct patients to wait at least one-half hour after taking BINOSTO before taking any other oral medications. 7.2 Aspirin In clinical studies, the incidence of upper gastrointestinal adverse events was increased in patients receiving concomitant therapy with daily doses of alendronate sodium greater than 10 mg and aspirin-containing products. 7.3 Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) BINOSTO may be administered to patients taking NSAIDs. In a 3-year, controlled, clinical study (n=2027) during which a majority of patients received concomitant NSAIDs, the incidence of upper gastrointestinal adverse events was similar in patients taking alendronate sodium 5 or 10 mg/day compared to those taking placebo. However, since NSAID use is associated with gastrointestinal irritation, caution should be used during concomitant use with BINOSTO. 7.4 Levothyroxine The bioavailability of alendronate was slightly decreased when BINOSTO and levothyroxine were co-administered to healthy subjects [see Clinical Pharmacology ( 12.3 )] .

7.1 Calcium Supplements/Antacids Co-administration of BINOSTO and calcium, antacids, or oral medications containing multivalent cations will interfere with absorption of BINOSTO. Therefore, instruct patients to wait at least one-half hour after taking BINOSTO before taking any other oral medications.

Excerpted — the section continues on the label. Read the full Drug Interactions section on DailyMed →

Not a complete list. The label covers the interactions the manufacturer studied or reported, and our own interaction database does not cover every medicine either. Bring your full medication list, including vitamins and herbal products, to your pharmacist.

🌿25 supplements and herbs with documented Alendronate interactions, ranked by severity Check Alendronate against a supplement or herb →

Before taking Alendronate

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  • Do not use with esophagus narrowing or achalasia, inability to sit or stand upright for 30 minutes, low blood calcium, or allergy to any ingredient.
  • The oral solution should not be given to people at higher risk of aspiration.
  • Use caution with active stomach or esophagus problems.
  • Not recommended with creatinine clearance under 35 mL/min. No adjustment is needed at 35 to 60 mL/min.
  • Pregnancy: stop when pregnancy is recognized. Bisphosphonates stay in bone for years, so there is a potential risk of fetal harm.
  • Breastfeeding: it is not known whether it passes into breast milk, so discuss with your doctor.
  • Not indicated for children.
  • Older adults: no overall differences in safety or effectiveness, though some may be more sensitive.
  • Liver problems: no dose adjustment is needed.

Alendronate overdose

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Too much alendronate may cause low calcium and phosphate and stomach or esophagus problems such as upset stomach, heartburn, esophagitis, gastritis or ulcer. The label advises giving milk or antacids to bind the drug. Do not induce vomiting, and stay fully upright. Seek medical help right away.

What Alendronate does in the body

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Alendronate binds to bone mineral and inhibits osteoclasts, reducing bone resorption. Markers of bone breakdown fell by roughly 50% to 70% in long-term studies. Bone formation markers also fall over time because the two processes are linked. Small, usually symptomless drops in blood calcium and phosphate can occur.

How your body processes Alendronate

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Very little alendronate is absorbed by mouth (under 1%), and food or drinks other than water nearly eliminate absorption. It is not metabolized. About half of an intravenous dose is cleared in the urine, and the rest goes to bone. Its terminal half-life is estimated to exceed 10 years because it is slowly released from the skeleton. Binosto 70 mg effervescent tablets and alendronate sodium 70 mg tablets are bioequivalent.

How to store Alendronate

▾

Store at 20° to 25°C (68° to 77°F) . Dispense in a tight, light-resistant container as defined in the USP, with a child-resistant closure (as required).

Written from the FDA-approved label with AI and reviewed by our pharmacy team. How we use AI →

25

Supplements & herbs that interact with Alendronate

25 supplements and herbal products have documented interactions with Alendronate in the licensed clinical database we use. Most are manageable — but your pharmacist should know about everything you take, including vitamins and herbals.

Severity mix
  • Major · 1
  • Moderate · 15
  • Minor · 9
ACTIVATED CHARCOAL Major CALCIUM Moderate COFFEE Moderate COFFEE CHARCOAL Moderate DOLOMITE Moderate EUROPEAN MANDRAKE Moderate GLUCOMANNAN Moderate GREEN COFFEE Moderate +17 more
Every supplement checked against Alendronate — ranked by severity The full interaction hub: 1 major · 15 moderate · 9 minor · every one linked to its full report. Check Alendronate against your exact supplements

Educational information from a licensed clinical database (Natural Medicines) — see our data sources & update cadence. Not medical advice: an interaction being documented does not mean it will happen to you; do not start or stop medications or supplements without professional guidance.

Alendronate: pharmacist answers to common questions

Quick, plain-English answers to the questions patients ask most about Alendronate — the kind of thing our pharmacy team would talk through with you at the counter.

What is alendronate for?

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It strengthens bone and lowers fracture risk in osteoporosis. Some products are also used for steroid-induced osteoporosis and Paget's disease of bone. Your pharmacy label shows which product you have.

How do I take it correctly?

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Take it first thing in the morning with a full glass of plain water, at least 30 minutes before food, drinks or other medicines. Stay upright for at least 30 minutes and until you eat. Never take it at bedtime.

What side effects are normal, and when should I call?

▾
Stomach upset, heartburn, nausea, constipation or diarrhea, and some bone or muscle aches can happen. Stop and call your doctor if you have trouble or pain swallowing, chest pain, or new or worsening heartburn. Also call for severe bone or muscle pain, new thigh or groin pain, or jaw problems.

Can I take my calcium or vitamins with it?

▾
Not at the same time. Calcium, antacids and similar products block absorption, so wait at least 30 minutes after alendronate. Your doctor may want you to get enough calcium and vitamin D, so ask when to fit them in.

Do I need to tell my dentist?

▾
Yes. Jaw bone damage has been reported with bisphosphonates, mostly after dental procedures like tooth extractions. Good oral hygiene matters, and your doctor and dentist can decide together about planned dental work.

Is it safe in pregnancy?

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The label says to stop it when pregnancy is recognized. The medicine stays in bone for years, so there is a potential risk to the baby. Tell your doctor if you are pregnant or planning to be.

Is Alendronate available over the counter?

▾
No. Alendronate is a prescription medicine: every Alendronate product listed with the FDA is prescription only, so it is not sold over the counter. Your prescriber decides whether it is appropriate for you, and your pharmacist dispenses it.

When was Alendronate first available?

▾
The earliest FDA record we hold for Alendronate is from 1995: its first approval in Drugs@FDA or its earliest product listing in the NDC Directory, whichever is older. Many older medicines were in use before their first formal FDA approval, so this is the earliest date on record, not necessarily when Alendronate was first used.

Who makes Alendronate?

▾
17 companies currently list Alendronate products in the FDA's NDC Directory, including Amneal Pharmaceuticals of New York LLC, A-S Medication Solutions, Aurobindo Pharma Limited. That count includes repackagers and distributors as well as manufacturers (companies that sell only the raw ingredient are not counted), so fewer companies actually make it; the label on your bottle names the one that supplied yours.

Answers drafted from the FDA-approved label with AI and reviewed by our pharmacy team. How we use AI →

More about Alendronate on HelloPharmacist

📊Alendronate supplement interactions25 checked — ranked by severity 🌿Drug & Supplement CheckerAlendronate vs. vitamins & herbs 💬Ask a PharmacistFree answer, usually < 24h 🔎NDC & pricing lookupFind Alendronate NDCs & costs 🅰️Browse Drugs A–ZLook up any medication
Detailed data & references for Alendronate Forms & strengths, pricing, billing codes, manufacturers, safety reports and sourcing — the data behind the page. Most people can stop here. Each section below opens on a tap.

Alendronate forms and strengths (how it comes)

Alendronate is available in 2 forms. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.

Tablet

By mouth
Brands Binosto Fosamax
How this form is used
What it may be used for
  • Alendronate, Alendronate Sodium and Fosamax tablets are used for osteoporosis in postmenopausal women (treatment and prevention) and in men.
  • Alendronate, Alendronate Sodium and Fosamax tablets are also used for glucocorticoid-induced osteoporosis and Paget's disease of bone.
  • Binosto effervescent tablets are used only to treat osteoporosis in postmenopausal women and to increase bone mass in men with osteoporosis.
Important instructions
  • Alendronate, Alendronate Sodium and Fosamax tablets should be swallowed whole with 6 to 8 ounces of plain water, at least 30 minutes before the first food, drink or medicine of the day.
  • Binosto is dissolved in about 4 ounces of plain room-temperature water. Wait at least 5 minutes after fizzing stops, stir, and drink it.
  • Binosto is taken once weekly, per its label.
  • With these tablet products, do not lie down for at least 30 minutes after taking and until after your first food.
Available strengths 6 strengths
5 mg 10 mg 35 mg 40 mg 70 mg 91.37 mg
95 FDA-listed product records ⓘ

Oral solution

By mouth
How this form is used
What it may be used for
  • Alendronate Sodium Oral Solution is used to treat osteoporosis in postmenopausal women.
  • Alendronate Sodium Oral Solution is used to increase bone mass in men with osteoporosis.
Important instructions
  • Alendronate Sodium Oral Solution is taken once weekly, per its label.
  • Alendronate Sodium Oral Solution should be swallowed and followed by at least 2 ounces of water.
  • Alendronate Sodium Oral Solution should be taken at least 30 minutes before the first food, drink or medicine of the day, and you should stay upright for at least 30 minutes.
  • Alendronate Sodium Oral Solution should not be given to people at increased risk of aspiration.
Available strengths 1 strength
70 mg/75 mL
4 FDA-listed product records ⓘ

Alendronate on the U.S. market: products, makers and brands

How Alendronate appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.

17 companies list 36 Alendronate product records with the FDA, mostly as tablet, oral solution; the earliest marketing or approval year on record is 1995. Brand names on the directory include Binosto, Fosamax; the rest are generics.

2
Dose forms ⓘ
17
Labelers (makers, repackagers, distributors)
4
Brand names
36
FDA-listed product records ⓘ
1995
Earliest FDA record ⓘ

FDA-listed product records by dose form (tablet variants merged) — FDA National Drug Code Directory. Record counts are not sales or prescription volume.

Also listed with the FDA, not a patient dose form: Powder (11) — bulk drug substance sold to compounders/manufacturers and multi-item kits. These aren’t counted in the dose-form total above.

Amneal Pharmaceuticals of New York LLC14%
A-S Medication Solutions11%
Aurobindo Pharma Limited8%
NorthStar Rx LLC8%
Rising Pharma Holdings, Inc.8%
Cipla USA Inc.6%
Other makers44%

Share of FDA-listed product records by manufacturer — FDA National Drug Code Directory. Record counts are not sales or prescription volume.

How widely Alendronate is used (Medicaid data)

A general measure of how commonly Alendronate is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.

Think of this as a proxy for how widely Alendronate is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.

645,853
Medicaid prescriptions filled (Q1–Q4 2025)
$6.2M gross Medicaid reimbursement (before mandatory rebates — net cost is lower)

How commonly is Alendronate prescribed? Of the 1,601 medications we measure, Alendronate ranks #231 by Medicaid prescriptions — more than 86% of them.

Where Alendronate ranks among the drugs we measure · Q1–Q4 2025 · neighbors ±5
Total prescriptions — #231 of 1,601
#226 Esomeprazole 663,042 Rx #227 Pravastatin 660,709 Rx #228 Rivaroxaban 655,610 Rx #229 Polymyxin B and Trimet... 651,823 Rx #230 Magnesium Oxide 648,844 Rx #231 Alendronate 645,853 Rx #232 Glimepiride 630,394 Rx #233 Doxepin (Insomnia) 628,470 Rx #234 Doxepin (Depression, A... 628,470 Rx #235 Doxepin 628,470 Rx #236 Ropinirole 626,420 Rx

Utilization by Alendronate product

Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.

The 70 mg oral tablet is the most-dispensed Alendronate product — about 91% of these Medicaid prescriptions.

alendronic acid 70 MG Oral Tablet Most dispensed

586,738 Medicaid prescriptions (Q1–Q4 2025) 91% of Alendronate prescriptions shown $5.4M gross reimbursement (before rebates) ≈ $9.16 per prescription (gross)

Summed across the 7 of 55 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 904431

alendronic acid 35 MG Oral Tablet

48,362 Medicaid prescriptions (Q1–Q4 2025) 7% of Alendronate prescriptions shown $437,713 gross reimbursement (before rebates) ≈ $9.05 per prescription (gross)

Summed across the 5 of 42 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 904396

alendronic acid 10 MG Oral Tablet

9,289 Medicaid prescriptions (Q1–Q4 2025) 1% of Alendronate prescriptions shown $125,641 gross reimbursement (before rebates) ≈ $14 per prescription (gross)

Summed across the 4 of 22 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 904419

alendronic acid 0.933 MG/ML Oral Solution

1,451 Medicaid prescriptions (Q1–Q4 2025) <1% of Alendronate prescriptions shown $257,145 gross reimbursement (before rebates) ≈ $177 per prescription (gross)

Summed across the 2 of 3 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 904447

alendronic acid 70 MG Effervescent Oral Tablet

13 Medicaid prescriptions (Q1–Q4 2025) <1% of Alendronate prescriptions shown $3,550 gross reimbursement (before rebates) ≈ $273 per prescription (gross)

Summed across the 1 of 7 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1248077

Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.

Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Alendronate, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 19 of 129 listed Alendronate NDCs with Medicaid activity.

Compare Alendronate products

A representative set of FDA-listed product records for Alendronate — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)

Showing 36 of 36 products — FDA National Drug Code Directory. See every product, package size and price: browse all 36 Alendronate NDCs →

Alendronate recall history

A recall is when a specific batch of a medicine is pulled from the market — usually a manufacturing issue, not a problem with the drug itself. Class I is most serious, Class III least.

The FDA’s enforcement reports list one Alendronate recall since July 2021. It is still ongoing. A recall names specific lots from one company, so check the lot number on your own bottle rather than assuming every product is affected; your pharmacist can check whether your supply came from an affected lot.

Ongoing Class II Apr 7, 2026 · Hikma Pharmaceuticals USA INC
This recall is being conducted due to out of specification assay results in a limited number of bottles that were stored on side.
  • Alendronate Sodium Oral Solution, 70 mg/75 mL, 75 mL, Rx only, 4 x 75 mL Single Dose Bottles, Distr. by: Hikma Pharmaceuticals USA Inc., Berkeley Heights, NJ 07922, NDC 0054-0282-59. Lots: Lot # AC2040A, Exp Date: 04/2026 FDA record D-0526-2026 →

Source: FDA enforcement (recall) reports, via openFDA; our copy was last updated Sep 24, 2026.

RxNorm Concept Web — From Ingredient to Every Form and Strength

This page starts with one ingredient concept (IN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). Combination products remain separate concepts with their own pages.

Ingredient (IN) Alendronate RxCUI 46041 3 dose forms · 7 strengths
  1. Dose form (SCDF) Effervescent Oral Tablet RxCUI 1536440 In current FDA listings
    Clinical drug / strength (SCD) alendronic acid 70 MG RxCUI 1248077
  2. Dose form (SCDF) Oral Solution RxCUI 904446 In current FDA listings
    Clinical drug / strength (SCD) alendronic acid 0.933 MG/ML RxCUI 904447

Look up RxCUI 46041 in the RxCUI Atlas →

RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.

💵 What Alendronate costs pharmacies (NADAC benchmark)

The national average invoice price pharmacies pay for the drug itself, from CMS's NADAC survey (data as of Sep 30, 2026). This is a supply-cost benchmark — not a retail price and not what you'd pay at the counter.

FormStrengthPharmacy acquisition benchmark
Tablet · Oral 35 mg $0.337 per tablet NDC details & price history
Solution · Oral 70 mg/75 mL $0.683 per mL NDC details & price history
Tablet, Effervescent · Oral 91.37 mg $71.23 per tablet NDC details & price history
Why show this? Your out-of-pocket cost depends on insurance, pharmacy markup, and discounts — but the acquisition benchmark tells you whether the medication itself is inexpensive or costly, which strengths cost more per dose, and whether a cash-price quote is in a reasonable range. Each row links to the NDC-level record with its full price history.

Source: CMS National Average Drug Acquisition Cost (NADAC), a survey of retail pharmacy invoice prices. Benchmarks shown are the range across package sizes of a representative product for each form and strength — other manufacturers' products may differ.

Alendronate brand names

Alendronate is sold under 2 brand names in the FDA directory — Binosto, Fosamax. A brand and its generic contain the same active ingredient; the brand name belongs to one company's product.

Binosto Fosamax

Who makes Alendronate: manufacturers and labelers

17 companies list Alendronate products with the FDA. By number of product records, the largest are Amneal Pharmaceuticals of New York LLC, A-S Medication Solutions, Aurobindo Pharma Limited. Labelers include manufacturers and repackagers; the product in your bottle depends on which one your pharmacy stocks.

Amneal Pharmaceuticals of New York LLC 5 A-S Medication Solutions 4 Aurobindo Pharma Limited 3 NorthStar Rx LLC 3 Rising Pharma Holdings, Inc. 3 Cipla USA Inc. 2 Exelan Pharmaceuticals Inc. 2 Hangzhou Minsheng Binjiang Pharmaceutical Co., Ltd. 2 Marlex Pharmaceuticals, Inc. 2 NuCare Pharmaceuticals, Inc. 2 Remedyrepack Inc. 2 ANI Pharmaceuticals, Inc. 1 Hikma Pharmaceuticals USA Inc. 1 Organon LLC 1 Preferred Pharmaceuticals Inc. 1 Proficient Rx LP 1 Radius Health, Inc. 1

Alendronate drug class (RxNorm)

Alendronate belongs to the Bisphosphonate class.

Pharmacologic class Bisphosphonate
Drug family (ATC) Bisphosphonates

Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.

Sources for this Alendronate page

Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.

📄
FDA-filed drug labels (SPL) Uses, dosing, warnings & side effects from SPL records retrieved through openFDA; the linked representative set can be verified on DailyMed. ✓ Linked label effective Dec 16, 2025
🏭
Forms, brands & labelersAggregated from ingredient-matched FDA National Drug Code Directory product records for Alendronate.
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Real-world reportsThe FDA Adverse Event Reporting System (FAERS), served through openFDA.
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Recalls & shortagesopenFDA drug-enforcement reports and the FDA drug-shortage database.
🧾 Clinical label set — FDA-filed SPL labels retained for Alendronate after exact ingredient or ingredient-combination matching and applicable route/form matching
Clinical labels in scope
26
Finished products in the current FDA directory
36
Companies listing them (makers, repackagers, distributors)
17
FDA labeler codes behind them ⓘ
17
Linked representative label ⓘ
Hangzhou Minsheng Binjiang Pharmaceutical Co., Ltd.
Linked label effective
Dec 16, 2025
Composite sections available
24
Linked SPL Set ID
a24fd39c-34a7-4de2-9439-781e612189ca
Linked SPL Document ID
460d461d-4807-2ed0-e063-6394a90aad4a
Open the linked representative label on DailyMed ↗

How this page is built

HelloPharmacist combines public FDA and NLM records and does not author the underlying clinical facts. The plain-language sections are written with AI from the FDA-approved label text and reviewed by our pharmacy team before publication. Hangzhou Minsheng Binjiang Pharmaceutical Co., Ltd. is the representative DailyMed label linked for verification and dates. This is general education, not medical advice: always talk to your doctor or pharmacist about your own medicines. How we build and review drug pages →