Prescription onlyLower-cost generic available

Fosamax Alternatives

(Alendronate)

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Compare Fosamax (Alendronate) to alternatives

These medications are comparable to Fosamax (Alendronate) or used for similar purposes.

Fosamax
(Alendronate)

Actonel
(Risedronate)

Boniva
(Ibandronate)

Reclast
(Zoledronate)

Prolia
(Denosumab)

Forteo
(Teriparatide)

Evista
(Raloxifene)

Miacalcin
(Calcitonin)

Miacalcin
(Calcitonin)

Prevents bone loss. Fosamax (Alendronate) is a first-choice treatment for osteoporosis and is available as a generic, but taking it can be a hassle.Prevents bone loss. Actonel (Risedronate) is a first-choice treatment for osteoporosis and is available as a generic, but how you have to take it can be a hassle.Prevents bone loss. Boniva is a first-choice treatment for osteoporosis and is available as a generic, but how you have to take it can be a hassle. It's also only approved for women, not men.Prevents bone loss. Reclast (Zoledronate) is a first-choice treatment for osteoporosis and is available as a generic, but you have to see a doctor to get each dose.Prevents bone loss. Prolia (Denosumab) is an effective and convenient treatment for osteoporosis if other options haven’t worked or aren’t appropriate for you. There’re risks of some rare side effects, so make sure you're following up with your doctor regularly.Prevents bone loss. Forteo (Teriparatide) is a good second-choice medication to treat bone loss, but it's only available as an injectable.Prevents bone loss and lowers your risk of breast cancer. Evista (Raloxifene) is effective at reducing bone loss and lowering the risk of breast cancer in postmenopausal women, but does carry the risk of blood clots.Coming soon.Coming soon.
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Reviews & ratings
Button Group. All currently active
Button Group. All currently active
4.291666666666667Fosamax
Reviews for Fosamax (Alendronate)
43%
of people say Fosamax (Alendronate) is worth it
30%
say it works well
18%
say it's a big hassle
Reviews for Actonel (Risedronate)
36%
7% vs. Fosamax (Alendronate)
19%
11% vs. Fosamax (Alendronate)
25%
7% vs. Fosamax (Alendronate)
Reviews for Boniva (Ibandronate)
30%
13% vs. Fosamax (Alendronate)
19%
11% vs. Fosamax (Alendronate)
27%
9% vs. Fosamax (Alendronate)
Reviews for Reclast (Zoledronate)
25%
18% vs. Fosamax (Alendronate)
25%
5% vs. Fosamax (Alendronate)
36%
18% vs. Fosamax (Alendronate)

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Side effects
FosamaxActonelBonivaReclastProliaForteoEvistacalcitonincalcitonin

We haven’t found good data for Fosamax side effects.

FDA side effect reports for Fosamax »

We haven’t found good data for Actonel side effects.

FDA side effect reports for Actonel »
  • Any serious side effect 3%
More Boniva side effects »
  • Pain 20%
  • Fever 17%
  • Rash 16%
  • Chills 15%
  • Muscle pain 13%
  • Pain in jaw 12%
  • Fatigue 12%
  • Nausea 10%
  • Headache 9%
  • Joint pain 8%
More Reclast side effects »
  • Hypercholesterolemia 1%
  • Ankle and leg swelling 1%
  • Ear, nose, or throat infection 1%
  • Sciatica 1%
  • Bone pain 1%
  • Passing gas 1%
  • Muscle pain 1%
  • Heart-related chest pain 1%
  • Rash 1%
  • Pain in extremity 1%
More Prolia side effects »
  • Dizziness 3%
  • Joint pain 2%
  • Fainting 2%
  • Leg cramps 2%
  • Muscle weakness 2%
  • Inflammation inside the nose 1%
  • Indigestion 1%
  • Vertigo 1%
  • Low mood disorder 1%
  • Tooth disorder 1%
More Forteo side effects »
  • Muscle spasms/leg cramps 4%
  • Leg cramps 3%
  • Sinus inflammation 3%
  • Leg or ankle swelling 2%
  • Muscle pain 2%
  • Sleep difficulty 2%
  • Rash 2%
  • Joint pain 2%
  • Weight gain 2%
  • Any side effect 1%
More Evista side effects »

We haven’t found good data for calcitonin side effects.

FDA side effect reports for calcitonin »

We haven’t found good data for calcitonin side effects.

FDA side effect reports for calcitonin »
How it works
FosamaxActonelBonivaReclastProliaForteoEvistacalcitonincalcitonin
Fosamax (Alendronate) is a bisphosphonate. It slows down osteoclasts, the cells that break down bone. This results in greater bone mass and lowers the possibility of fractures.Actonel (Risedronate) is a bisphosphonate. It slows down osteoclasts, the cells that break down bone. This results in greater bone mass and lowers the possibility of fractures.Boniva (Ibandronate) is a bisphosphonate. It slows down osteoclasts, the cells that break down bone. This results in greater bone mass and lowers the possibility of fractures.Reclast (Zoledronate) is a bisphosphonate. It slows down osteoclasts, the cells that break down bone. This results in greater bone mass and lowers the possibility of fractures.Prolia (Denosumab) is a monoclonal antibody. It blocks a protein that sends signals to break down your bones, and therefore prevents bone loss.Forteo (Teriparatide) works by stimulating cells that build up and strengthen your bones.Evista (Raloxifene) is a selective estrogen receptor modulator (SERM). It acts like estrogen to make your bones stronger and less likely to break, and also protects breast and uterus tissues from other estrogen effects.Coming soon.Coming soon.
Type of medication
FosamaxActonelBonivaReclastProliaForteoEvistacalcitonincalcitonin
BisphosphonatePrescription only
BisphosphonatePrescription only
BisphosphonatePrescription only
BisphosphonatePrescription only
Monoclonal antibodyPrescription only
Osteoporosis
Parathyroid hormone
Prescription only
Osteoporosis
Selective estrogen receptor modulator
Prescription only
Coming soon.
Coming soon.
Available as
FosamaxActonelBonivaReclastProliaForteoEvistacalcitonincalcitonin
  • Pill
  • Effervescent tablet
  • Liquid
  • Pill
  • Extended release
  • Pill
  • Injection
  • Injection
  • Injection
  • Injection
  • Pill
  • Nasal spray
  • Nasal spray
Used for (click to learn more)
FosamaxActonelBonivaReclastProliaForteoEvistacalcitonincalcitonin
  • Hypercalcemia Paget's disease Postmenopausal osteoporosis
  • Hypercalcemia Paget's disease Postmenopausal osteoporosis
Risk factors for serious side effects
FosamaxActonelBonivaReclastProliaForteoEvistacalcitonincalcitonin
      • Oral or dental surgery
      • Cancer
      • Poor oral hygiene
          Detailed Fosamax (Alendronate) risks & warnings »
          Coming soon.Coming soon.Coming soon.Coming soon.Coming soon.Coming soon.Coming soon.Coming soon.
          Pregnancy category
          FosamaxActonelBonivaReclastProliaForteoEvistacalcitonincalcitonin
          CFDA pregnancy category (Weigh risks vs. benefits)

          Research studies with animals found harmful effects on unborn babies. It hasn’t been properly studied in humans. The benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

          See the FDA package insert
          CFDA pregnancy category (Weigh risks vs. benefits)

          Research studies with animals found harmful effects on unborn babies. It hasn’t been properly studied in humans. The benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

          See the FDA package insert
          CFDA pregnancy category (Weigh risks vs. benefits)

          Research studies with animals found harmful effects on unborn babies. It hasn’t been properly studied in humans. The benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

          See the FDA package insert
          DFDA pregnancy category (Weigh risks vs. benefits)

          Research studies with real people found harmful effects on unborn babies, but the benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

          See the FDA package insert
          XFDA pregnancy category (Unsafe)

          Research studies with real people or animals found harmful effects on unborn babies. If you’re pregnant, the risks to your unborn baby outweigh the benefits.

          See the FDA package insert
          CFDA pregnancy category (Weigh risks vs. benefits)

          Research studies with animals found harmful effects on unborn babies. It hasn’t been properly studied in humans. The benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

          See the FDA package insert
          XFDA pregnancy category (Unsafe)

          Research studies with real people or animals found harmful effects on unborn babies. If you’re pregnant, the risks to your unborn baby outweigh the benefits.

          See the FDA package insert
          CFDA pregnancy category (Weigh risks vs. benefits)

          Research studies with animals found harmful effects on unborn babies. It hasn’t been properly studied in humans. The benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

          See the FDA package insert
          CFDA pregnancy category (Weigh risks vs. benefits)

          Research studies with animals found harmful effects on unborn babies. It hasn’t been properly studied in humans. The benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

          See the FDA package insert
          Alcohol
          No specific alcohol-related info.No specific alcohol-related info.No specific alcohol-related info.No specific alcohol-related info.No specific alcohol-related info.No specific alcohol-related info.
          • Regular exercise, cutting back on smoking, and drinking less alcohol can also reduce your risk of bone loss.
          No specific alcohol-related info.No specific alcohol-related info.
          Food
          No specific food-related info.
          • If you're taking the extended release medication, take it after your first meal of the day with at least a half cup of water.
          • Stay sitting or standing, and Don't take any other medications, vitamins or supplements for at least 60 minutes after you take the tablet until you've had your first food of the day.
          No specific food-related info.No specific food-related info.No specific food-related info.
          • Take 1 tablet daily with or without food about the same time each day. It’s important to read the information you get with your medicine about how to take Evista (Raloxifene).
          No specific food-related info.No specific food-related info.
          Kidneys and liver
          No specific kidneys and liver-related info.No specific kidneys and liver-related info.No specific kidneys and liver-related info.No specific kidneys and liver-related info.No specific kidneys and liver-related info.No specific kidneys and liver-related info.No specific kidneys and liver-related info.No specific kidneys and liver-related info.No specific kidneys and liver-related info.
          Sex
          No specific sex-related info.No specific sex-related info.No specific sex-related info.No specific sex-related info.No specific sex-related info.No specific sex-related info.No specific sex-related info.No specific sex-related info.No specific sex-related info.
          Sleep
          No specific sleep-related info.No specific sleep-related info.No specific sleep-related info.No specific sleep-related info.No specific sleep-related info.No specific sleep-related info.No specific sleep-related info.No specific sleep-related info.No specific sleep-related info.
          Weight
          No specific weight-related info.
          • Consider adding weight-bearing exercises as part of your exercise routine.
          • Consider adding weight-bearing exercises as part of your exercise routine.
          No specific weight-related info.No specific weight-related info.No specific weight-related info.No specific weight-related info.No specific weight-related info.No specific weight-related info.
          Upsides and benefits
          FosamaxActonelBonivaReclastProliaForteoEvistacalcitonincalcitonin
          • Lowers your risk of bone fractures.
          • Available as a generic medication.
          • Available in two forms: one that can be taken once a day or another that's taken once a week.
          • Comes as a regular tablet, an oral solution, or effervescent tablets meant to be dissolved in water.
          • Available in generic.
          • Available in oral tablets that can be taken once or twice a month, once a week, or once a day.
          • Available in generic.
          • Available in oral tablets that can be given once a month or once a day.
          • Also available as shot given into your vein every 3 months.
          • Available in generic.
          • You only have to take this once a year.
          • Prolia (Denosumab) is effective at preventing bone loss, making your bones stronger and lowering your chance of getting a fracture.
          • Only need to get an injection every 6 months, so you don’t have to remember to take something every day.
          • If you're unable to use bisphosphonates or are still having fractures despite being on other medications, Forteo (Teriparatide) can be a good alternative.
          • You can start using Forteo (Teriparatide) as soon as you stop using bisphosphonates.
          • Evista (Raloxifene) doesn’t affect the breast or uterus the same way that estrogen does, so the risk of cancer is much lower.
          • Taking Evista (Raloxifene) with calcium and vitamin D improves spine and hip bone health and lowers the risk of fractures.
          • Lowers total cholesterol and low-density lipoprotein (LDL) cholesterol (the bad cholesterol).
          Coming soon.
          Downsides and risks
          FosamaxActonelBonivaReclastProliaForteoEvistacalcitonincalcitonin
          • You need to take it the first thing in the morning with a full glass of water.
          • Not good for people who can't sit or stand upright for at least 30 minutes in the morning.
          • The use of bisphosphonates increases your risk of other types of fractures not related to osteoporosis (called atypical fractures).
          • Can cause bad heartburn or stomach problems.
          • You have to remain upright for at least 30 minutes after you take the medication, which can be a problem if you have mobility issues.
          • You have to take it first thing in the morning with a full glass of water.
          • You have to remain upright for at least 60 minutes after you take the medication, which can be a problem if you have mobility issues.
          • Only approved to treat and prevent osteoporosis in women who have gone through menopause.
          • You have to take it first thing in the morning with a full glass of water.
          • You have to go to your doctor's office or an infusion center to get each dose by IV infusion.
          • Approved for women only after they’ve reached menopause. Don’t use this if you’re pregnant or planning to become pregnant.
          • Can lower blood calcium levels. You might need to take calcium supplements to prevent this.
          • Not available as a generic.
          • Only available as a brand medication, so it can be expensive.
          • You have to inject this every day, so it may not be a good option if you don't like needles.
          • Shouldn't take this longer than 18 to 24 months since it can increase the risk of bone cancers.
          • Can only take Evista (Raloxifene) once you’re in menopause. You can't take it if you're pregnant or breastfeeding.
          • Evista (Raloxifene) isn’t as effective as tamoxifen at lowering the risk of invasive breast cancer.
          • Shouldn’t take it with any other forms of estrogen (pills, patches, or injection).
          • It doesn’t increase bone strength as much as estrogen does and isn’t effective for treating hot flashes.
          Coming soon.Coming soon.
          Tips from our pharmacists for people taking the medication
          FosamaxActonelBonivaReclastProliaForteoEvistacalcitonincalcitonin
          • Take Fosamax (Alendronate) first thing in the morning with a full glass of water before eating or drinking anything else, including other medicines.
          • The pill must be swallowed whole.
          • Stay upright for at least 30 minutes after taking the medicine, and don't eat or drink anything except plain water during that time.
          • Make sure you take enough calcium and vitamin D to allow this medicine to work.
          • Can cause an upset stomach, joint pain, back pain, or heartburn.
          • Stop taking the medicine and let your doctor know if swallowing becomes painful, if you have chest pain, or if any of the side effects worsen.
          • If you have dental work coming up, get it done before starting this medicine since some people have experienced serious jaw problems while on Fosamax (Alendronate).
          • If you're taking the fast release medication, take it first thing when you wake up by swallowing the whole pill with a full glass of water.
          • Don't eat or drink anything for 30 minutes after you've taken the fast release medication.
          • If you're taking the extended release medication, take it after your first meal of the day with at least a half cup of water.
          • Stay sitting or standing and Don't take any other medications, vitamins or supplements for at least 30 minutes after you take the medication.
          • If you forget to take your dose, skip it and take it the following morning.
          • Some of these medications are only taken once or twice a month, others are taken once a week and others once a day. Talk to your pharmacist if you're not sure.
          • If you have pain with swallowing, around your chest or stomach, or new or worsening heartburn, talk to your doctor.
          • Call your doctor if you develop pain in your jaw, hips or thighs.
          • Keep taking your calcium and vitamin D.
          • Consider adding weight-bearing exercises as part of your exercise routine.
          • Can be taken as a tablet or as an intravenous infusion.
          • Take the tablet first thing when you wake up by swallowing the whole pill with a full glass of plain water.
          • Don't eat or drink anything for 60 minutes after you've taken the tablet.
          • Stay sitting or standing, and Don't take any other medications, vitamins or supplements for at least 60 minutes after you take the tablet until you've had your first food of the day.
          • Take the 150 mg tablet on the same day every month.
          • If you forget to take the 150mg tablet on your chosen day each month, take it on the next day in the morning.
          • Some of these medications are only taken once a month, others once a day. Talk to your pharmacist if you're not sure.
          • If you have pain with swallowing, around your chest or stomach, or new or worsening heartburn, talk to your doctor.
          • Call your doctor if you develop pain in your jaw, hips or thighs.
          • Keep taking your calcium and vitamin D.
          • Consider adding weight-bearing exercises as part of your exercise routine.
          • Given as an intravenous infusion.
          • Eat normally and drink at least two glasses of liquid before your infusion.
          • Talk to your doctor if you develop swelling, pain, or a sore in your jaw.
          • Call your doctor if you develop pain in your hips, thighs or legs.
          • You can take acetaminophen (Tylenol) to lower fever and chills from the infusion.
          • If you have to have dental or oral surgery, tell your surgeon that you're taking this medication.
          • Drink plenty of liquids while you're on this medication.
          • Remember to get your shot every 6 months. Write it down on your calendar.
          • If your doctor also told you to take calcium and vitamin D, remember to take them as well. They'll work with Prolia (Denosumab) to help protect your bones.
          • Can cause skin irritation, joint pain, limb pain, and back pain.
          • Let your doctor know if you start getting more infections.
          • Let your dentist know that you’re taking Prolia (Denosumab) since it can cause problems in the jaw bone after dental procedures.
          • You should be sitting or lying down when you inject Forteo (Teriparatide) since it can make you dizzy.
          • You should inject Forteo (Teriparatide) under the skin in either your thigh or stomach.
          • Make sure the liquid in the vial of Forteo (Teriparatide) is clear and colorless before you inject it. Don't use it if it looks cloudy, colored, or if you see particles inside.
          • Take 1 tablet daily with or without food about the same time each day. It’s important to read the information you get with your medicine about how to take Evista (Raloxifene).
          • Your doctor may tell you to take calcium and vitamin D with Evista (Raloxifene) to prevent osteoporosis (bone thinning and loss), especially if you don’t get enough in your diet.
          • Regular exercise, cutting back on smoking, and drinking less alcohol can also reduce your risk of bone loss.
          Coming soon.Coming soon.
          Learn more
          More about FosamaxSide effectsReviews & ratingsAlternativesFDA package insert
          More about ActonelSide effectsReviews & ratingsFDA package insert
          More about BonivaSide effectsReviews & ratingsFDA package insert
          More about ReclastSide effectsReviews & ratingsFDA package insert
          More about ProliaSide effectsReviews & ratingsFDA package insert
          More about ForteoSide effectsReviews & ratingsFDA package insert
          More about EvistaSide effectsReviews & ratingsFDA package insert
          More about calcitoninSide effectsFDA package insert
          More about calcitoninSide effectsFDA package insert