SIDE EFFECTS: Stomach pain, constipation, gas, or nausea may occur. If these effects persist or worsen, notify your doctor or pharmacist promptly. Tell your doctor immediately if any of these unlikely but serious side effects occur: jaw pain, an increase in muscle or bone pain, black stools, vomit that looks like coffee grounds. This medication may infrequently cause serious irritation and ulcers of the esophagus. If you notice any of the following unlikely but very serious side effects, stop taking alendronate and consult your doctor or pharmacist immediately: new or worsening heartburn, chest pain, trouble or painful swallowing. A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching, swelling, dizziness, trouble breathing. If you notice other effects not listed above, contact your doctor or pharmacist.

PRECAUTIONS: Before taking alendronate, tell your doctor or pharmacist if you are allergic to it; or to other bisphosphonates; or if you have any other allergies. This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: disorders of the esophagus (e.g., esophageal stricture or achalasia), severe swallowing problems (high aspiration risk), inability to stand or sit upright for at least 30 minutes, low calcium levels, severe kidney disease. Before using this medication, tell your doctor or pharmacist your medical history, especially of: trouble swallowing, stomach/intestinal disorders (e.g., ulcers). Infrequently, serious jawbone problems (osteonecrosis) have occurred in people taking similar medication. Most people were also using other medications or had conditions which might have actually caused the jawbone problem. If you have cancer, anemia, blood clotting disorders, infections in the mouth or other diseases of the mouth, or poor dental hygiene, see your dentist for a full examination/treatment before you start alendronate. Make sure he/she knows your entire medical history, any cancer radiation treatments, and also all the medications you are using, especially corticosteroids such as prednisone, cancer chemotherapy, and alendronate. Consult your dentist for more details. This medication should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor. It is not known whether this drug passes into breast milk. Consult your doctor before breast-feeding.