Alendronate and Cholecalciferol (Oral)

Alendronate And Cholecalciferol is a prescription combination medication that is designed to treat the symptoms of thinning bones that is associated with osteoporosis in women post-menopause.


Alendronate and cholecalciferol combination is primarily intended as a prescription-strength treatment of thinning of the bone experienced by women suffering from osteoporosis, although in some cases it can be used to treatment who are afflicted with a loss of bone mass as a result of the disease. If deciding to use this prescription medication there are certain risks that should be weighed against the potential benefits of the treatment. This decision should be reached between patient and doctor, but the following risk factors should be taken into consideration:

A History of Allergies

Make sure that your doctor knows if you have had any unusual reactions to any medication in the past, or if you have any known allergies to any substance. If you have any doubt, allergy testing may be available. Typical allergies that may have an impact on the effect of this medication include such common varieties as animal or insect allergies, allergies to foods or additives, or allergies to certain plants.

Pediatric Treatment

The use of an alendronate and cholecalciferol regimen is not a recommended course of treatment for children and is not normally prescribed as such.

Geriatric Treatment

Studies that have been conducted on geriatric subjects have not found any specific problems with a treatment regimen of alendronate and cholecalciferol for osteoporosis experienced by elderly patients.


The potential effects on pregnant women who are experiencing osteoporosis symptoms are unknown because of lack of studies pertaining to this course of treatment. In addition, the potential risks to women who are breastfeeding children are also unknown. If you are pregnant or think you may be pregnant consult with your doctor regarding stopping or starting an Alendronate and Cholecalciferol regimen. Follow all instructions that pertain to taking this medication in the guide that is included with the prescription.


This medication should be taken with a full glass of water without food, preferably on an empty stomach. It is taken in the morning before ingestion of any food or beverages. If multiple medications are being taken in the morning, this medication should be taken first. If taken with food or beverages within thirty minutes of the dose the body may not absorb the full dose and the benefit of the medication can be nullified. Other medications or supplements with a high calcium or mineral content may decrease absorption of the medication as well. The tablet should be swallowed whole, not chewed, as this can also work against the efficacy of the dosage. Sucking or chewing on the tablet can cause irritation in the throat or mouth. To prevent irritation, remain sitting or standing for the 30 minute period to help the medicine make its journey down the esophagus. Avoid laying down after taking the pill.

Dietary Concerns

The diet of the patient can affect the potency of an Alendronate and Cholecalciferol regimen. A healthy diet that includes sufficient vitamin D and calcium content can help to increase the overall bone health recovered during the course of treatment. However, food or supplements containing these nutrients should not be ingested in the 30 minutes after taking the pill. Follow all directions from your physician regarding the use of this medication and do not skip doses or stop using it without first consulting with a medical professional.

Lifestyle Considerations

You need to inform your doctor about the following habits as they may affect your prescription or the amount of its dosage:

  • Strenuous exercise
  • Occupational heavy lifting
  • Smoking
  • Drinking Alcohol

Condition treated

  • Osteoporosis

Type of medicine

  • Bisphosphonates

Side Effects

Alendronate and Cholecalciferol may have some unintended effects along with those for which it was prescribed. These effects may or may not occur depending on the individual, but some of them may be serious enough to merit medical attention. Inform your medical professional immediately if you notice any of these potentially serious side effects.

  • Heartburn
  • Difficulty swallowing
  • Chest pain
  • Difficulty breathing
  • Shortness of breath
  • Irregular heartbeat
  • Vomiting
  • Sore throat
  • Spitting up blood
  • None pain
  • Muscle pain
  • Joint pain
  • Cramping
  • Abdominal pain
  • Diahrea
  • Swelling in extremities
  • Blistering
  • Skin peeling
  • Itching
  • Hives
  • Chills
  • Fever
  • Cough
  • Convulsions
  • Rapid weight gain or loss
  • Confusion
  • Mood changes
  • Tremors
  • Fatigue
  • Numbness
  • Skin lesion
  • Loss of appetite
  • Immobility
  • Loosening of teeth
  • Loss of appetite
  • Severe pain
  • Unexplained inflammation or stiffness

In addition to these serious side effects, some side effects may occur that are not usually cause to seek immediate medical attention. Many of them are to be expected as your body adjusts to the medication and will subside in a short period of time. Your doctor or health care professional may have information on how to prevent or cope with these side effects. If any of these side effects become difficult to tolerate or have affected you for too long of a period of time you should consult with your physician.

These side-effects include:

This is not a comprehensive list and additional side effects may pop up from time to time. If any unusual symptom occurs while taking Alendronate and Cholecalciferol inform your doctor as this may be an unexpected or undocumented side effect of the medication.


The dosage that is prescribed by your doctor will vary based on your specific needs and medical condition at the time of prescription. This will be an individualized amount and may diverge greatly from what will be prescribed to other patients. Follow all directions from your doctor and indications that are on the label of your prescription. The information in this section is only to inform you of average or typical doses of this medication. If your doctor prescribes a different dose please follow those directions, and do not make any alterations to the dosage without consulting with your doctor first.

A prescription of Alendronate and Cholecalciferol will be taken as a pill or several pills depending on the strength of the dose and the number of doses taken each day will vary based on your specific condition. Generally, doses are taken first thing in the morning without food. The time allotted between doses may vary based on your doctor's discretion.

Directions for oral dosage route

  • Adults - One tablet will be taken at least 30 minutes before breakfast or any beverage other than water. A typical dose is 70mg of alendronate and 70mg of alendronate. Tablets also contain vitamin D3.
  • Children - Use is not recommended.
  • Treatment of osteoporosis in men - One tablet will be taken at least 30 minutes before breakfast or any beverage other than water. A typical dose is 70mg of alendronate and 70mg of alendronate. Tablets also contain vitamin D3.
  • Children - Use is not recommended.

If for any reason you miss a dose of Alendronate and Cholecalciferol do not double dose within a 24 hour period but rather take your next dose at the prescribed time to get back on the regular dosing schedule. Take it in the morning following the missed dose if not on a daily schedule but resume doses on the prescribed day to maintain a stable dosing schedule.


Certain medications can trigger very undesirable reactions when combined and should not be used at all. In some cases, these prescriptions are so necessary that they must be used together even though they may have an adverse reaction. In such cases, doctors may alter or reduce the dose that is received as a precaution to account for these reactions. When you are taking Alendronate and Cholecalciferol it is imperative that your doctor is informed of all medications and supplements that are being taken at the same time. Take special care if there are any of the medications that are listed below. While this is not a complete list of all medications that will have an interaction it has been included based on the significance of their potential interactions. Normally, the use of any of these medications with Alendronate and Cholecalciferol is not recommended, but in some cases mixing the medications may be necessary. If you have any concerns about this ask your doctor if the doses can be altered or if an alternative medication is available for prescription.

Parathyroid Hormone

Other Interactions

Alendronate and Cholecalciferol can have some negative interactions with certain food an drink. Usually eating or drinking anything but water should be avoided at the time that the dose is taken. Using alcohol or tobacco when you are using this medication could also interact poorly, so inform your doctor if you are indulging these habits. Your doctor will have directions on what to do if you are in need of assistance in smoking cessation or abstaining from alcohol. The following warnings related to food intake should be regarded and discussed with your physician:

Dairy Food


When taking Alendronate and Cholecalciferol there are a number of factors that may require you to proceed with caution. Certain medical problems that you have in addition to osteoporosis may make it hazardous to take this medication. Make certain that your physician has access to a full medical history and is aware if you have any other medical problems. The following list of conditions are indicators that there may be an increased health risk associated with taking this prescription.

  • Cancer
  • Blood clotting disorders
  • Blood or bone marrow problems (such as leukemia)
  • Anemia
  • Infections
  • Dental problems
  • Recent surgery
  • Gum disease
  • Loss or extraction of teeth
  • Kidney disease
  • Stomach problems
  • Gastrointestinal distress
  • Vitamin D deficiency
  • Esophagus problems
  • Difficulty swallowing
  • Hypocalcemia
  • Inability to sit upright for 30 minutes or more

Patients who have these symptoms in addition to osteoporosis before or after taking Alendronate and Cholecalciferol should not begin or continue the regimen. Alendronate and Cholecalciferol have been known to cause irritation of the esophagus. If you have a reason to think that there has been any damage to the esophagus, use of the medication should be discontinued until you can speak with a physician about your concerns. Some symptoms that can indicate that there has been damage to the esophagus include heartburn, difficulty swallowing, chest pain, and a feeling that something is stuck in the throat.

All current healthcare providers need to be aware when you are starting a new regimen of an alendronate and cholecalciferol combination. This includes dental providers, and if you have a dental procedure while taking Fosamax Plus D there may be an increased risk of developing a severe problem with the lower jaw. Keep your doctor apprised of any new or worsening medical problem, especially with the teeth or jaw. If severe bone, joint, or muscle pain is experienced while taking Alendronate and Cholecalciferol your physician needs to be informed. The medication can also lower the amount of calcium in the blood, causing a serious medical condition that is characterized by twitching, muscle spasms, and numbness. Call your doctor immediately if you experience these symptoms. Extended use of the medication may increase the risk of fractures in the thigh bone, and your doctor should be informed if there is any dull or aching pain in the thighs, groin, or hips as this could be an indicator that there is an increased chance of a life-threatening fracture. Do not take any medications or supplements along with Alendronate and Cholecalciferol that have not been discussed with your doctor. This includes both prescription and over-the-counter vitamins and herbal supplements.


Alendronate and Cholecalciferol should be stored in a closed container in an area that is room temperature. It should be kept away from heat, direct sunlight, and excessive moisture. It should not be refrigerated or frozen. It also should be kept secure and away from areas where it can be reached by children. When it is no longer needed or your physician has discontinued its use, the remainder of the medicine should be disposed of. If you have any questions regarding its disposition please ask your healthcare provider how to dispose of unneeded prescription medication


Alendronate and Cholecalciferol is a medication prescribed to treat osteoporosis in women who are of post-menopausal age, although it is also used in some cases to treat men. It is only available with a prescription and is not recommended for off-label treatments or for use in pediatric medicine.

The oral route of Alendronate and Cholecalciferol is marketed under the brand name Fosamax Plus D and contains alendronate sodium, a bisphonate, and cholecalciferol (vitamin D3). The active ingredient acts as an inhibitor to osteoclast-mediated bone resorption associated with osteoporosis. These synthetic analogs of pyrophosphate bind to hydroxyapatite found in bone mass. Alendronate sodium has a chemical description of bisphosphonic acid monosodium salt trihydrate. Cholecalciferol is an odorless powder with a crystalline consistency and is not water-soluble but is soluble in organic solvents or vegetable oils.

Fosamax Plus D for oral administration contains the active ingredients in the following amounts:

  • Alendronate monosodium salt trihydrate: 91.37 mg
  • Cholecalciferol: 140 mcg

In addition, it is composed of the following inactive ingredients:

  • microcrystalline cellulose
  • lactose anhydrous
  • medium chain triglycerides
  • gelatin
  • croscarmellose sodium
  • sucrose
  • colloidal silicon dioxide
  • magnesium stearate
  • butylated hydroxytoluene
  • modified food starch
  • sodium aluminum silicate.

The combination of alendronate and cholecalciferol in Fosamax Plus D works to combat the symptoms of osteoporosis in the following manner. The Alendronate is a natural bisphosphonate that alters the regular cycle of bone formation and breakdown in the body. It treats the condition by slowing bone loss while increasing bone mass. A regular regimen of Alendronate can prevent bone loss or fractures as a result of brittle bones. When combined with Cholecalciferol, a form of vitamin D, it can regulate and improve the absorption of calcium from the stomach and increase the effectiveness of calcium in the body. It is used both as a treatment and a preventative measure against osteoporosis. In some cases, Fosamax Plus D may be used for purposes that are not listed in the medication guide that comes with the prescription, such as clinical trials or in combination with another prescription. It should not be taken if the patient is currently afflicted with low levels of calcium in the blood, also known as hypocalcemia, or if they experience any difficulty with swallowing. In addition, patients taking this medication need to sit or stand upright for at least 30 minutes after swallowing the dose. Inability to stay upright can cause serious problems in the esophagus.

A regimen of the oral route of Alendronate and Cholecalciferol should be closely monitored by a physician. Regular check-ups and visits to measure progress are essential to proper treatment of osteoporosis. To ensure that the medicine is working as intended, blood and urine screenings may be used to check for any unwanted effects.

Last Reviewed:
December 10, 2017
Last Updated:
April 05, 2018
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