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This safety information outlines important warnings associated with the use of alendronate (Fosamax). Understanding these risks and precautions will help ensure safe use of the medication. Discuss any concerns with your healthcare provider.

• Stomach and Esophagus Irritation: Alendronate may cause irritation and ulcers in the stomach and esophagus. To reduce this risk, take the medication with 6-8 ounces of water and remain upright for at least 30 minutes afterward. Inform your healthcare provider if this is difficult for you or if you experience new swallowing pain or heartburn, as these may indicate ulcers. Individuals at higher risk include those taking other stomach-irritating medications or those with existing stomach or esophageal issues.

• Calcium Level Management: Alendronate can further lower calcium levels, especially if you already have low blood calcium or vitamin D levels. Ensure these are treated before starting alendronate and take any prescribed supplements. Report any new muscle spasms or twitching to your provider. Those with Paget's disease or taking steroids like prednisone are at increased risk.

• Muscle and Bone Pain: Though rare, severe pain in the bones, muscles, or joints may occur, potentially months after starting the medication. This is more common in postmenopausal women. Consult your healthcare provider if you experience such pain, which typically resolves after discontinuing alendronate.

• Jaw Bone Health: Alendronate may cause rare jaw bone problems, particularly if you undergo major dental surgery, have poor oral hygiene, or use certain medications. Inform your healthcare provider and dentist about any planned dental procedures. Watch for mouth or jaw pain, swelling, or infection, and report these to your provider. Risk factors include cancer, poor-fitting dentures, and prolonged use of alendronate.

• Leg Fractures: Rare leg fractures have been reported, sometimes with minimal force. Although it's unclear if alendronate is the cause, report any new dull or aching pain in your hips or thighs. Those taking steroids may be more susceptible.

• Kidney Health: Alendronate is not suitable for individuals with severe kidney issues. Consult your healthcare provider if you have kidney problems to determine if alendronate is right for you.

Contraindications: Avoid using alendronate if you have conditions that prevent you from sitting or standing upright for 30 minutes, have issues with food passage through your throat or gut, or have low calcium levels (hypocalcemia). Always consult with your healthcare provider if any of these conditions apply to you.

When taking this medication, you might encounter some common side effects, which are usually mild. These include stomach pain, constipation, diarrhea, bloating, passing gas, nausea, and headaches. If these symptoms persist or become bothersome, it's advisable to consult a healthcare provider.

In some cases, more serious side effects can occur, although they are less common. These include muscle, bone, and joint pain, heartburn, indigestion, and ulcers in the esophagus. If you experience any of these symptoms, especially if they worsen, it’s important to seek medical advice.

Rarely, severe side effects may arise, requiring immediate medical attention. These include significant allergic reactions such as trouble breathing, hives, or swelling of the face, lips, tongue, or throat. Additionally, low calcium levels, characterized by symptoms such as muscle spasms or tingling sensations, should be addressed promptly. If you observe any new or unusual symptoms, contact a healthcare professional for guidance.