Do not take Alendronate

if you are allergic to alendronic acid or any of the other ingredients of this medicine

if you have certain problems with your gullet (oesophagus – the tube that connects your mouth with your stomach) such as narrowing or difficulty swallowing

if you cannot stand or sit upright for at least 30 minutes

if your doctor has told you that you have low blood calcium

If you think any of these apply to you, do not take the tablets. Talk to your doctor first and follow theadvice given.

Warnings and precautions

Talk to your doctor or pharmacist before taking Alendronate if:
• you suffer from kidney problems,
• you have, or have recently had, any swallowing or digestive problems,
• your doctor has told you that you have Barrett’s oesophagus (a condition associated with changes in the cells that line the lower oesophagus),
• you have been told you have trouble absorbing minerals in your stomach or intestines (malabsorption syndrome),
• you have been told you have low blood calcium,
• you have poor dental health, gum disease, a planned dental extraction or you don’t receive routine dental care,

• you have cancer,

• you are undergoing chemotherapy or radiotherapy,
• you are taking angiogenesis inhibitors (such as bevacizumab, or thalidomide) which are used in the treatment of cancer,
• you are taking corticosteroids (such as prednisone or dexamethasone) which are used in the treatment of such conditions as asthma, rheumatoid arthritis, and severe allergies,

• you are or have been a smoker (as this may increase the risk of dental problems).

You may be advised to have a dental check-up before starting treatment with Alendronate.

It is important to maintain good oral hygiene when being treated with Alendronate. You should have routine dental check-ups throughout your treatment and you should contact your doctor or dentist if you experience any problems with your mouth or teeth such as loose teeth, pain or swelling.

Irritation, inflammation or ulceration of the gullet (oesophagus – the tube that connects your mouth with your stomach) often with symptoms of chest pain, heartburn, or difficulty or pain upon

swallowing may occur, especially if patients do not drink a full glass of water and/or if they lie down less than 30 minutes after taking Alendronate. These side effects may worsen if patients continue to take Alendronate after developing these symptoms.

Children and adolescents

Alendronate should not be given to children and adolescents less than 18 years of age.

Other medicines and Alendronate

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.

It is likely that calcium supplements, antacids, and some oral medicines will interfere with the absorption of Alendronate if taken at the same time.

Certain medicines for rheumatism or long-term pain called NSAIDs (e.g. acetylsalicylic acid oribuprofen) might cause digestive problems. Therefore, caution should be used when these medicines are taken at the same time as Alendronate.

Alendronate with food and drink

It is likely that food and beverages (including mineral water) will make Alendronate less effective if taken at the same time.