Alendronate treatment to prevent osteoporotic fractures

Alendronate sodium, an aminobisphosphonate, has been approved by the Food and Drug Administration for the prevention and treatment of osteoporosis in postmenopausal women, thus providing an effective alternative to estrogen replacement therapy in women who cannot or will not take estrogen. Large, randomized, controlled trials have demonstrated approximately a 50% reduction in vertebral, hip, and wrist fractures. Efficacy and safety beyond 3 years has not been determined. To avoid esophagitis and maximize absorption, alendronate should be taken with 180 to 240 mL of water on arising for the day, allowing at least 30 minutes before the first food, beverage, or oral medication of the day is ingested.