The worst side effect of osteonecrosis of the jaw (ONJ), which is rare. ONJ is a side effect of bisphosphonates in general, not just alendronate. There were many lawsuits against Merck alledging ONJ injuries from people who took alendronate when Merck had the patent on it.

A 2008 paper in the Journal of the American Dental Association cast doubts on the alendronate-ONJ connection. The author found that people who took bisphosphonates intravenously had a higher risk of ONJ, but people who took them orally, as most do, had a lower risk. This was based on review of 700,000 medical cases.

Osteonecrosis of the jaw has been recognized for over a century. Indeed, there was an epidemic of Phossy Jaw in the second half of the Nineteenth Century. Even at the time public health practitioners recognized the connection between yellow phosphorus (P4O10) workplace exposure phossy jaw. Hence the name Phossy Jaw.

That epidemic of Phossy Jaw notably affected people who worked in match factories. Matches of the day used yellow phosphorus. It is believed that when the phosphorus oxide gets in the body, it reacts with amino acids and water and carbon dioxide to produce alendronate and other bisphosphonates.

(Contrary to urban legend, no connection has been found between consumption of cola drinks - which contain phosphoric acid - and phossy jaw.)
 

Other possible side effects

Bone/joint/muscle pain. Somewhat related to ONJ, severe bone and joint has been reported during bisphosphonate treatment. Pain might show up immediately after the medicine is started or in several months later. Doctors have a range of options for dealing with osteoporosis, so be sure to speak up about any pain you experience.

Esophagitis, dysphagia, esophageal ulcers, esophageal erosions, and esophageal stricture have been reported with oral bisphosphonates.

Occular side effects has been reported in a few cases.

Hypocalcemia - low calcium level in the blood. Your doctor may have a work-around or put you on a different type of medicine. Slightly lower calcium levels due to alendronate usually poses no problem, but patients who are vitamin D-deficient can get hypocalcemia. Patients taking alendronate should receive at least 1000 mg of elemental calcium and 800 IU of vitamin D per day unless they have hypercalcemia.

Intravenous administration can make the patient feel like he/she has the flu and develop a fever. The white blood cell count may be diminished. This usually passes in a few days.

Some people get stomach cramps or other gastrointestinal problems (gastrointestinal mucosa irritation) on alendronate. While gastrointestinal problems are side effects of many drugs, with some medicines you can reduce these effects by taking the drug with a meal. Unfortunately, absorption of alendronate is poorer with food - this is one reason you shouldn't eat or drink anything for at least 30 minutes after taking the medicine.

Paget's disease patienrs taking 40 mg/day are more apt to get gastrointestinal problems than osteoporosis patients who take one pill per week.

Note : This product information is intended only for residents of the India. Taj Pharmaceuticals Limited,  medicines help to treat and prevent a range of conditions—from the most common to the most challenging—for people around the world.

Information for Health Care Professionals

*** Please consult local Prescribing Information for any product before use. This website is an international information resource for healthcare professionals with an interest in disease management. This website is not intended to replace the advice of a qualified healthcare professional. Above brand is a trademark of the Taj group of companies (Taj Pharmaceuticals Limited).

          
 Print page   Send by mail