Prescription medication · Bisphosphonate
alendronate
Also sold as Fosamax. Binosto treats osteoporosis, a condition that weakens bones and makes them more likely to break.
Data updated 2026-05-15
- 98,033
- FDA reportsOften reported
- 2
- InteractionsFew interactions
- 98% less
- Generic vs brandHuge savings
- 1
- Recall record
What the data shows
alendronate (Fosamax) is a prescription Bisphosphonate, more reported than most tracked drugs (98,033 FDA reports), whose generic costs a fraction of the brand (about 98% less).
Reporting volume reflects how widely a drug is used and studied, not how dangerous it is, a FAERS report documents a temporal association, never proof of cause.
alendronate (Fosamax) is a prescription Bisphosphonate. Binosto treats osteoporosis, a condition that weakens bones and makes them more likely to break.
Binosto is a medicine that helps make your bones stronger. It is used to treat osteoporosis in women after menopause and in men.
Verify with FDA → · CMS NADAC pricing →
Drug Pricing (NADAC)
Brand Price
$35.13/unit
Generic Price
$0.61/unit
Generic Savings
98%
Generic Available
Yes (6 manufacturers)
Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →
What it does
Binosto treats osteoporosis, a condition that weakens bones and makes them more likely to break.
Common side effects
Abdominal pain, Acid reflux, Constipation
Key warnings
Binosto can cause problems with your esophagus.
The sections below are summarized in plain English from alendronate's FDA-approved prescribing information. They describe what the official label says, and are not personal medical advice.
How It Works
Binosto belongs to a class of drugs called bisphosphonates. It works by slowing down the breakdown of bone in your body. This helps to increase bone density and reduce the risk of fractures.
How to Take It
Take one 70 mg Binosto tablet once a week. Dissolve the tablet in about 4 ounces of plain water at room temperature. Wait 5 minutes after the fizzing stops, stir for 10 seconds, and then drink the solution. Take it at least 30 minutes before you eat, drink, or take other medicines in the morning. Do not lie down for at least 30 minutes after taking Binosto.
This is a plain-language summary of alendronate's FDA labeling, not individualized dosing advice. Ask a pharmacist or prescriber before changing how you take this medication.
Pregnancy & Breastfeeding
Stop taking Binosto if you become pregnant. Bisphosphonates can stay in your bones for many years and could potentially harm the baby's skeleton.
This is a plain-language summary of alendronate's FDA labeling, not individualized advice. Ask a pharmacist or prescriber about pregnancy or breastfeeding on this medication.
Missed Dose
If you miss your weekly dose, take it the next morning after you remember. Do not take two doses on the same day. Go back to your regular weekly schedule.
This is a plain-language summary of alendronate's FDA labeling, not individualized advice. Ask a pharmacist or prescriber what to do about your specific missed dose.
Storage
Store Binosto tablets at room temperature (68°F to 77°F) in the original blister pack, away from moisture.
Side Effects (from patient reports)
Based on 98,033 FDA adverse event reports.
Most-reported reactions
Adverse reactions in FAERS for alendronate, by number of reports
- Pain
Pain
13,524 reports
- Tiredness
Tiredness
12,776 reports
- Fracture of the thigh bone
Fracture of the thigh bone
11,334 reports
- Joint pain
Joint pain
11,000 reports
- Rheumatoid arthritis
Rheumatoid arthritis
9,938 reports
- Hair loss
Hair loss
9,883 reports
- Stomach discomfort
Stomach discomfort
9,811 reports
- Systemic lupus erythematosus
Systemic lupus erythematosus
8,987 reports
- Skin rash
Skin rash
8,724 reports
- Pemphigus
Pemphigus
8,686 reports
What this shows Bars show how often each reaction was reported, not how likely it is to happen, a report records a temporal association, never proof that the drug caused it.
Reports over time
Adverse-event reports filed for alendronate each year to the FDA Adverse Event Reporting System (FAERS).
Year-to-year volume tracks usage, prescribing, and scrutiny, not a change in per-patient risk. Source: FDA FAERS.
Where alendronate sits
alendronate has more FDA adverse-event reports than 85% of the drugs FAERS tracks. A high position reflects how widely a drug is used and watched, not how dangerous it is.
Percentile across all drugs PlainMeds tracks by FAERS report volume. The dot is alendronate; the line is the median (50th percentile).
FDA Adverse Event Report Analysis
Detailed analysis of 98,033 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2003–2025.
Total Reports
98,033
Reports Mentioning Death
11,123
11.3% of reports — not proof of cause
Hospitalization Reports
36,609
Top Indication
Osteoporosis
Gender Distribution
Age Distribution
Most Reported Adverse Reactions (FAERS)
| # | Reaction | Reports |
|---|---|---|
| 1 | PAIN | 13,527 |
| 2 | FATIGUE | 12,775 |
| 4 | FEMUR FRACTURE | 11,334 |
| 5 | ARTHRALGIA | 11,003 |
| 6 | RHEUMATOID ARTHRITIS | 9,937 |
| 7 | ALOPECIA | 9,882 |
| 8 | ABDOMINAL DISCOMFORT | 9,812 |
| 9 | SYSTEMIC LUPUS ERYTHEMATOSUS | 8,987 |
| 10 | RASH | 8,726 |
| 11 | PEMPHIGUS | 8,686 |
| 12 | FALL | 8,164 |
| 13 | GLOSSODYNIA | 8,076 |
| 14 | ARTHROPATHY | 8,061 |
| 15 | SWELLING | 7,603 |
| 16 | NAUSEA | 7,565 |
Reactions in Death Reports
Reactions in Hospitalization Reports
Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation
Serious Warnings
Binosto can cause problems with your esophagus. Follow the directions for taking it carefully. If you have new or worsening heartburn, pain when swallowing, or chest pain, stop taking Binosto and call your doctor. This medicine may also cause severe bone, joint, or muscle pain. If you develop these symptoms, stop taking Binosto and contact your doctor.
Known Drug Interactions
( 7.1 ) Use caution when co-prescribing aspirin/nonsteroidal anti- inflammatory drugs that may worsen gastrointestinal irritation. 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.
Mechanism: Both of these medicines can be hard on your stomach and esophagus. Using them together increases the chance of developing irritation or ulcers in your digestive system.
What to do: Use caution when taking these drugs together. Tell your doctor if you have any stomach pain or heartburn.
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) ] .
Mechanism: Taking these two drugs at the same time can prevent the body from absorbing enough alendronate into the system.
What to do: Talk to your doctor about timing your doses, as you may need to take these medications at different times of the day.
This is a plain-language summary of interactions documented in FDA labeling, not individualized advice. Ask a pharmacist or prescriber before combining medications.
Common Questions
Can I chew or swallow the Binosto tablet?
Can I use flavored water to dissolve the tablet?
What if I can't stand or sit upright for 30 minutes?
Can I take Binosto with other medications?
What should I do if I experience heartburn after taking Binosto?
Do I still need to take calcium and vitamin D supplements?
Can I take Binosto at bedtime?
What if I have kidney problems?
Can I take Binosto if I have problems with my esophagus?
Is it okay to take NSAIDs with Binosto?
What are the common side effects of alendronate?
Does alendronate interact with other medications?
What drug class is alendronate?
Is there a generic version of alendronate?
Is alendronate safe during pregnancy?
Has alendronate been recalled?
Active Recalls
This recall is being conducted due to out of specification assay results in a limited number of bottles that were stored on side.
Hikma Pharmaceuticals USA INC
Related Medications in Bisphosphonate
Other drugs grouped near alendronate - same-class peers and common alternatives.
abaloparatide
Tymlos
Tymlos is a medicine to treat osteoporosis.
Compare with alendronate →
calcitonin
Miacalcin, Fortical
Calcitonin is a medicine that helps manage calcium levels in your body.
Compare with alendronate →
denosumab
Prolia, Xgeva
Stoboclo is a medicine that helps to treat osteoporosis and increase bone mass.
Compare with alendronate →
ibandronate
Boniva
Ibandronate (Boniva) is a medicine that helps treat and prevent bone loss in women after menopause.
Compare with alendronate →
risedronate
Actonel
Risedronate sodium delayed-release tablets help treat osteoporosis after menopause.
Compare with alendronate →
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What the FDA Data Shows for alendronate
The FDA label for alendronate (sold under brand names such as Fosamax) classifies it as a prescription-only medication in the Bisphosphonate class. Binosto treats osteoporosis, a condition that weakens bones and makes them more likely to break. Official labeling lists 7 commonly reported side effects, including Abdominal pain, Acid reflux, Constipation.
Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 98,033 voluntary reports. The database also lists 2 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated moderate severity. NADAC pricing from CMS shows a generic unit cost of $0.61 versus $35.13 for the brand - a 98% generic savings.
Report counts do not establish causation, a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history (currently 1 recall record on file), and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice, always consult a licensed healthcare provider before starting, stopping, or changing any medication.
Data Sources
Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).
FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.
Last updated: February 24, 2025
Read our methodology - how this data is sourced, computed, and verified.
Data currency: FDA FAERS adverse-event reports through 2025, CMS NADAC acquisition-cost pricing effective December 2024, compiled and last refreshed May 2026. See our methodology for per-source dates and refresh cadence. Spot a figure that looks wrong? Report a correction.
All federal data sources used on this page
- FDA Orange Book - approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed - NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) - post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm - standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files - federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database - current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages