Alendronate (Fosamax) Nursing Considerations

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Generic Name


Trade Name



Osteoporosis (aging, menopause, corticosteroid induced)


Inhibits osteoclast activity leading to inhibition of resorption of bone

Therapeutic Class

Bone resorption inhibitor

Pharmacologic Class


Nursing Considerations

• Take first thing in the morning with full glass of water 30 min prior to eating
• Assess serum calcium and vitamin D
• May lead to muscle pain

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Hey guys, let’s talk about Alendronate, also known as Fosamax. This is an oral medication and it can also come in a solution form and here is a picture of the oral form. So the therapeutic class of alendronate is a bone resorption inhibitor. In other words, this is what it does to the body. The pharmacologic class, or the chemical effect on the body is it’s a biphosphonate, which inhibits osteoclasts. So the mechanism of action is it works by inhibiting osteoclastic activity. This is my bone here, and it leads to inhibition of resorption of bone. It’s indicated for osteoporosis, which could be due to menopause, aging, or even corticosteroid-induced. Some side effects that are seen with Alendronate are muscle pain, bone pain, hypocalcemia, which is related to the inhibition of osteoclast activity, and also abdominal pain. Okay, guys, let’s look at a few nursing considerations, super important.

You will want to assess your patient’s serum, calcium, and vitamin D levels. Also, teach your patient to take Alendronate first thing in the morning with a full glass of water, and guys, your patient must remain upright for 30 minutes after taking this medication. And also they cannot eat anything. These instructions are super important because Alendronate can cause esophageal ulcerations if they are not followed. Also, a rare side effect that you should be aware of is osteonecrosis of the jaw. So if your patient says they’re having pain, do not blow them off. In surgery, we had to remove a patient’s jaw because of this due to not taking Alendronate properly. That’s it for Alendronate or Fosamax. Now go out and be your best self today. And as always happy nursing.

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