Fosamax Interactions: Other Medications, Alcohol, and More
Fosamax (alendronate) is a prescription drug that’s used for osteoporosis and Paget’s disease. This drug can interact with other medications and some supplements. For example, Fosamax can interact with NSAIDs and certain antacids.
Fosamax is used in adults to:
An interaction can occur because one substance causes another substance to have a different effect than expected. Interactions can also occur if you have certain health conditions.
Keep reading to learn about Fosamax’s possible interactions. And for more information about Fosamax, including details about its uses, see this article.
* In this article, we use the terms “male” and “female” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.
Does Fosamax interact with other drugs?
Before you start taking Fosamax, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Fosamax interacts with herbs or vitamins and supplements, see the “Are there other interactions with Fosamax?” section below.)
If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist. They can answer additional questions you may have, such as what drugs should not be taken with Fosamax.
The table below lists drugs that may interact with Fosamax. Keep in mind that this table does not include all drugs that may interact with Fosamax. For more information about some of these interactions, see the “Drug interactions explained” section.
| Drug group or drug name | Drug examples | What can happen |
| antacids that contain calcium, magnesium, or aluminum | • aluminum hydroxide/magnesium hydroxide/simethicone (Mylanta, others) • calcium carbonate (Tums) | can make Fosamax less effective |
| deferasirox (Jadenu, Exjade) | — | can increase the risk for digestive side effects of Fosamax and deferasirox |
| nonsteroidal anti-inflammatory drugs (NSAIDs) | • aspirin • ibuprofen (Advil, Aleve) | can increase the risk of digestive side effects of Fosamax and NSAIDs |
| parathyroid hormone and analogs | • teriparatide (Forteo) • parathyroid hormone (Natpara) | can make parathyroid hormone and parathyroid hormone analogs less effective |
| phosphate binders | • lanthanum (Fosrenol) | can make Fosamax less effective |
| proton pump inhibitors (PPIs) | • omeprazole (Prilosec) • esomeprazole (Nexium) | can make Fosamax less effective |
| sucralfate (Carafate) | — | can make Fosamax less effective |
| thyroid hormone replacements | • liothyronine (Cytomel) • levothyroxine (Synthroid, others) | can make Fosamax less effective |
When should I avoid Fosamax?
Certain health conditions or other factors could raise your risk of harm if you take Fosamax. In such cases, your doctor may not prescribe Fosamax for you. These are known as contraindications. The list below includes contraindications of Fosamax.
If you have a problem with your esophagus that delays emptying or are at higher risk for aspiration: Fosamax can cause side effects that affect your esophagus. Examples include esophageal ulcers, bleeding, perforation (holes), and stricture (narrowing). Doctors typically won’t prescribe Fosamax if you have an existing esophageal problem that delays emptying from the esophagus due to this risk. They’ll also usually avoid prescribing Fosamax if you’re at increased risk for aspiration.
If you have an inability to sit or stand up for at least 30 minutes: After taking each dose of Fosamax, you must remain seated or standing upright for at least 30 minutes. This lowers the risk of esophageal side effects caused by Fosamax. Your doctor will likely suggest treatments for osteoporosis other than Fosamax if you’re unable to remain seated or upright for at least 30 minutes.
If you have hypocalcemia: Usually, doctors won’t prescribe Fosamax if you have hypocalcemia (low blood calcium levels) until the condition is treated. Taking Fosamax can worsen hypocalcemia.
If you’ve had an allergic reaction: If you’ve had an allergic reaction to Fosamax or any of its ingredients, your doctor likely won’t prescribe Fosamax for you. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better options for you.
Before you start taking Fosamax, talk with your doctor if any of the factors above apply to you. Your doctor can determine whether Fosamax is safe for you to take.
Does Fosamax interact with alcohol?
Fosamax is not known to interact with alcohol. But your doctor may suggest limiting or avoiding alcohol to lower your risk for osteoporosis or to help prevent your osteoporosis from worsening. (Fosamax is prescribed to treat and prevent osteoporosis in certain people.)
If you have questions about consuming alcohol while using Fosamax, talk with your doctor or pharmacist.
Drug interactions explained
Learn more about certain drug interactions that can occur with Fosamax.
Interaction with antacids that contain calcium, magnesium, or aluminum
Fosamax can interact with antacids that contain calcium, magnesium, or aluminum. Antacids are used to treat heartburn.
Examples of antacids that contain calcium, magnesium, or aluminum include:
What could happen
Taking Fosamax with an antacid that contains calcium, magnesium, or aluminum can prevent your body from absorbing Fosamax. This can make Fosamax less effective.
What you can do
If you take Fosamax with an antacid that contains calcium, magnesium, or aluminum, you’ll need to avoid taking these drugs at the same time. Take antacids that contain calcium, magnesium, or aluminum at least 30 minutes after you take your Fosamax dose.
If you have questions about taking Fosamax with an antacid that contains calcium, magnesium, or aluminum, talk with your doctor or pharmacist.
Interaction with nonsteroidal anti-inflammatory drugs (NSAIDs)
Fosamax can interact with NSAIDs. NSAIDs are used to treat acute pain. This includes pain related to arthritis, the common cold or flu, and period pain, among other aches and pains.
Examples of NSAID medications include:
What could happen
Both Fosamax and NSAIDs can cause digestive side effects, including ulcers in your gastrointestinal (GI) tract. Taking these medications can increase the risk of these side effects.
What you can do
Usually, this interaction is not severe enough to stop doctors from prescribing Fosamax and NSAIDs together. Often, doctors can monitor you for symptoms of digestive side effects during treatment.
If you have another medical condition that raises this risk, your doctor may be more cautious about prescribing Fosamax and an NSAID together. For example, if you have peptic ulcer disease or a history of bleeding in your GI tract, your doctor may suggest avoiding this treatment combination.
Talk with your doctor if you have questions about using Fosamax and NSAIDs together.
Interaction with phosphate binders
Fosamax can interact with phosphate binders. Phosphate binders are used to lower the amount of potassium in your system in people with kidney conditions, such as chronic kidney disease.
Examples of phosphate binder medications include:
What could happen
Taking Fosamax with a phosphate binder can block your body from absorbing Fosamax. This can make Fosamax less effective.
What you can do
If you need to take Fosamax and a phosphate binder, take the phosphate binder at least 2 hours after you take Fosamax. Separating the times when you take your dose can help prevent this interaction.
Are there other interactions with Fosamax?
Fosamax may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See below for details. Note that the information below does not include all other possible interactions with Fosamax.
Does Fosamax interact with supplements?
Before you start using Fosamax, talk with your doctor and pharmacist about any herbs or vitamins and supplements you take. Sharing this information with them may help you avoid possible interactions.
It’s important to note that you should separate taking Fosamax and any herbs or vitamins and supplements you take, even if specific interactions are not discussed below. Fosamax should be taken first thing upon waking up, at least 30 minutes before taking any other medication or supplement.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
Fosamax interactions with herbs
There are currently no reports of Fosamax interacting with specific herbs. But this doesn’t mean that interactions with herbs won’t be recognized in the future.
For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while taking Fosamax.
Fosamax interactions with vitamins and minerals
Fosamax can interact with the minerals calcium, magnesium, and iron. It can also interact with multivitamins that contain these minerals. You should wait at least 30 minutes after taking Fosamax before you take any product that contains calcium, magnesium, or iron.
Talk with your doctor or pharmacist if you have additional questions about Fosamax, vitamins, and minerals.
Does Fosamax interact with food?
There are no specific foods to avoid while taking Fosamax. But, it’s important to note that you should not eat food at least 30 minutes before or 30 minutes after taking Fosamax. If you take Fosamax with food, the interaction could decrease the level of the drug in your body. This may make Fosamax less effective.
Does Fosamax interact with vaccines?
There are currently no reports of Fosamax interacting with vaccines. If you have questions about getting certain vaccines during your Fosamax treatment, talk with your doctor.
Does Fosamax interact with lab tests?
There are currently no reports of Fosamax interacting with lab tests. If you have questions about having certain lab tests during your treatment with Fosamax, talk with the healthcare professional ordering the test.
Does Fosamax interact with cannabis or CBD?
There are currently no reports of Fosamax interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with Fosamax.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Does my health history affect whether I should take Fosamax?
Certain medical conditions or other health factors may raise the risk of interactions with Fosamax. Before taking Fosamax, talk with your doctor about your health history. They’ll determine whether Fosamax is right for you.
Health conditions or other factors that might interact with Fosamax include:
If you have a problem with your esophagus that delays emptying or are at higher risk for aspiration. To learn more, see the “When should I avoid Fosamax?” section in this article.
If you have an inability to sit or stand up for at least 30 minutes. To learn more, see the “When should I avoid Fosamax?” section in this article.
If you have hypocalcemia. To learn more, see the “When should I avoid Fosamax?” section in this article.
Other problems with your esophagus or digestive tract. Fosamax can cause side effects that affect your esophagus and digestive tract. If you have esophagitis or another condition involving your esophagus or digestive tract, taking Fosamax could worsen your condition. You may also have a higher chance of digestive side effects caused by Fosamax.
Low vitamin D level. If you have a low vitamin D level, your doctor will likely want to treat this before or during treatment with Fosamax. Having low vitamin D can negatively affect your bone health, including raising your risk for osteoporosis.
Dental condition or scheduled dental surgery. Fosamax can rarely cause dental-related side effects, including osteonecrosis of the jaw. Having dental surgery while taking Fosamax can increase this risk. You may also be at higher risk if you have a dental condition, such as gum disease.
Severe kidney problems. If you have a severe kidney problem, such as end stage kidney disease, your doctor may suggest a treatment other than Fosamax. Your body relies on your kidneys to get rid of Fosamax after you take a dose. Having a severe kidney problem can mean your body doesn’t get rid of Fosamax as well. This can cause an elevated level of Fosamax in your system, which may raise your risk for side effects.
Pregnancy. Doctors typically recommend stopping Fosamax during pregnancy. If you’re pregnant or planning a pregnancy, talk with your doctor before taking Fosamax.
Breastfeeding. It’s not known whether it’s safe to take Fosamax while breastfeeding. If you’re breastfeeding or planning to breastfeed, talk with your doctor about your options.
Allergic reaction. If you’ve had an allergic reaction to Fosamax or any of its ingredients, your doctor will likely not prescribe Fosamax. This is because using the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.
Common questions about Fosamax and interactions
What is Fosamax used for?
Fosamax is primarily used to treat and prevent osteoporosis in postmenopausal women and increase bone mass in men with osteoporosis.
Can I take Fosamax with other medications?
Fosamax can interact with certain medications, including calcium supplements, antacids, and some anti-inflammatory drugs. It’s important to consult your healthcare provider before combining it with other medications.
How does alcohol interact with Fosamax?
Consuming alcohol while taking Fosamax may increase the risk of stomach-related side effects and bone loss. It is advisable to limit alcohol intake while on Fosamax.
What should I avoid while taking Fosamax?
Avoid lying down for at least 30 minutes after taking Fosamax and avoid eating or drinking anything other than water during this period to ensure proper absorption.
Can I take Fosamax with food?
No, Fosamax should be taken on an empty stomach with a full glass of water to ensure that it is absorbed properly.
Are there any over-the-counter drugs I should avoid while on Fosamax?
Yes, avoid taking over-the-counter medications that contain calcium, magnesium, or aluminum within two hours of taking Fosamax as they can interfere with its absorption.
Find answers to some frequently asked questions about Fosamax and possible interactions.
What pain reliever can I take with Fosamax?
Fosamax can interact with nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and aspirin. To learn more about this interaction, see the “Drug interactions explained” section in this article.
Other pain relievers, such as acetaminophen (Tylenol), may be safe for you to take, as they aren’t expected to interact with Fosamax. But, other pain relievers may interact with other medications you take. Or, they may interact with other medication conditions you have. For this reason, talk with your doctor or pharmacist to learn more about pain relievers that are safe for you to use.
Can I take Tylenol while taking Fosamax?
Yes, if your doctor says this is OK. Tylenol and Fosamax aren’t reported to interact.
That said, Tylenol can interact with other medications and medical conditions. Although it doesn’t interact with Fosamax, it’s best to ask your doctor or pharmacist if Tylenol is safe for you before taking it.
How can I prevent interactions?
Taking certain steps can help you avoid interactions with Fosamax. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:
It’s also important to understand Fosamax’s label and other paperwork that may come with the drug. Colored stickers that describe interactions may be on the label. And the paperwork (sometimes called the patient package insert or medication guide) may have other details about interactions. (If you did not get paperwork with Fosamax, ask your pharmacist to print a copy for you.)
If you have trouble reading or understanding this information, your doctor or pharmacist can help.
Taking Fosamax exactly as prescribed can also help prevent interactions.
Disclaimer: adoctor has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
Great post! It’s so important to be aware of potential interactions when taking medications like Fosamax. I’ve seen firsthand how even common substances can affect medication efficacy. Your detailed breakdown of interactions with other medications and alcohol is incredibly helpful. Thanks for sharing and helping us stay informed!
This is an incredibly informative post! Understanding the interactions Fosamax can have with other medications and substances like alcohol is vital for anyone prescribed this medication. It’s great to see such detailed insights that can help people make informed decisions about their health. Thank you for sharing this valuable information!
This is a really informative post! Understanding the interactions between Fosamax and other substances is crucial for anyone taking this medication. It’s particularly helpful to know about the potential effects with alcohol and other medications, as this can prevent adverse reactions and ensure the treatment is as effective as possible. Thanks for sharing such valuable insights!
This is a very informative post! Understanding the interactions of Fosamax with other medications and substances like alcohol is crucial for managing osteoporosis effectively. It’s important for patients to have this kind of detailed information to prevent any potential adverse effects. Thanks for sharing!
This article provides essential insights into the interactions of Fosamax, which is incredibly helpful for anyone on this medication. Understanding the effects of mixing Fosamax with other drugs, alcohol, and different lifestyle factors is crucial for managing osteoporosis effectively. Thank you for shedding light on these important considerations!
This is a very informative post on Fosamax interactions! It’s crucial for patients to be aware of potential interactions with other medications and factors like alcohol consumption. Understanding these interactions can help avoid adverse effects and enhance the effectiveness of the treatment. Thanks for shedding light on such an important topic.
This is a very informative post on Fosamax interactions! Understanding how this medication interacts with other drugs and substances like alcohol is crucial for anyone taking it. Thank you for breaking down the potential risks and considerations. It’s always important to consult with a healthcare provider before making any changes to medication routines. Keep up the great work in spreading awareness!
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