Alendronate comes in both tablet and liquid solution forms. Tablets are taken with a glass of water in the morning, before breakfast. The manufacturer also recommends drinking some water when the drug is taken in solution form. You aren't supposed to eat within 30 minutes of taking the drug. It is available only by presecription and should be taken only under a doctor's care. You should not take alendronate while pregnant.

A 2010 check of a popular on-line pharmacy showed generic alendronate selling for $256 for 100 tablets (5 mg/tablet). The branded Fosamax was $295 for 100 tablets.

Doctors set the dosage level for each patient. Typically osteoporosis patients take 5 to 10 mg/day. 5 mg/day is often used to prevent osteoporosis. Paget's disease patients take a much higher doase - 40 mg/day.

Alkaline phosphatase is an enzyme that can be used as a biomarker in alendronate treatment. Along with blood levels of calcium and phosphorus, it is periodically measured in patients. Bone density is often measured to see if the drug is working as intended.

Alendronate is not approved for pregnant women, and because the drug stays in the body for years, it is not often used if there is a change the patient may get pregnant in the future.

Because of the drug's impace on the bone system, patients often are advised to take calcium and Vitamin D supplements. Women over age 50 should consume 1200-1500 mg/day of elemental calcium and 800-1000 int. units/day of vitamin D.

It is commonly thought that osteoporosis results only from a reduction in bone mass (i.e., from bone loss). However, the condition can also result from never having obtained adequate bone mass during a person’s adolescent and young adult years. Therefore, the risk factors for osteoporosis begin early in life and include genetic, clinical, medical, behavioral, and dietary vulnerabilities. Additionally, risk factors that occur in combinations augment the chance of osteoporosis in an additive fashion. In other words, someone with two risk factors has a higher risk than someone with just one risk factor.

Genetic risk factors include: Caucasian or Asian ethnicity, family history of fractures, and family history of osteoporosis. African Americans have the lowest occurrence of osteoporosis of all ethnic populations. Clinical risk factors for osteoporosis include: female gender, older age, estrogen deficiency, and low weight or small body size. Medical risk factors include: anorexia nervosa, hypogonadism, gastrointestinal disorders, malabsorption syndromes, hematologic disorders, and use of certain medications (e.g., glucocorticoids, diuretics, anticonvulsants, immunosuppressive medications, asthma medications, and some antibiotics). Behavioral and dietary risk factors include: excessive or too little exercise, smoking, high caffeine intake, consuming too much alcohol, and calcium and Vitamin D deficiencies.