Osteofos
✅ Strengthens bone density
✅ Reduces fracture risk
✅ Treats osteoporosis
✅ Prevents bone loss
✅ Enhances bone health
Osteofos contains Alendronic Acid.
✓ Medically reviewed by Morgan Ellis — Pharmacy Researcher · 8 years experience · Last reviewed: May 2026
Quick Answer
Osteofos (alendronic acid (alendronate) 70 mg weekly bisphosphonate) is a once-weekly oral bisphosphonate (alendronate) used to treat and prevent postmenopausal osteoporosis, osteoporosis in men, and glucocorticoid-induced osteoporosis. It must be taken on an empty stomach with strict upright posture for 30–60 minutes.
- Alendronic acid 70 mg once-weekly oral tablet
- Indications: postmenopausal osteoporosis, osteoporosis in men, glucocorticoid-induced osteoporosis
- CRITICAL administration: empty stomach, 200 ml plain water, upright 30–60 minutes
- WHO-GMP certified manufacturer
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What is Osteofos?
Osteofos is alendronic acid (alendronate) — a nitrogen-containing bisphosphonate that inhibits osteoclast-mediated bone resorption. It binds to hydroxyapatite in bone matrix; when osteoclasts resorb bone, they ingest alendronate, which then inhibits farnesyl diphosphate synthase, disrupting osteoclast function and triggering apoptosis. The result is reduced bone resorption, gradual increase in bone mineral density, and reduced fracture risk.
Indications
- Postmenopausal osteoporosis — first-line oral therapy; landmark trials (FIT, FLEX) demonstrated reduced vertebral, hip, and wrist fracture
- Osteoporosis in men with low BMD or fragility fracture
- Glucocorticoid-induced osteoporosis — patients on long-term prednisolone >5 mg/day for >3 months should usually have prophylactic bisphosphonate
- Paget’s disease of bone
Critical administration rules
- Take ONE 70 mg tablet once weekly, on the SAME day each week, FIRST THING in the morning
- Take with at least 200 ml of PLAIN water (no mineral water, no juice, no coffee, no tea, no milk)
- STAY UPRIGHT (sitting or standing) for at least 30 minutes (1 hour is preferred)
- Do NOT eat or drink anything other than plain water for 30–60 minutes
- DO NOT take any other oral medication, calcium, vitamin D, or supplement for at least 30–60 minutes
Bisphosphonates have notoriously poor oral bioavailability (less than 1%). Any food, any other oral medication, or any non-water beverage drops absorption to near zero. Lying down or recumbent posture for the first 30–60 minutes risks oesophageal retention — alendronate is severely irritating to oesophageal mucosa and has caused oesophagitis, oesophageal ulceration, and oesophageal stricture, particularly in elderly patients with reflux. Failing the administration rules wastes the dose and risks injury. If you cannot stay upright for 30 minutes, alendronate is not the right drug for you — consider IV zoledronic acid annually instead.
| Indication | Dose |
|---|---|
| Postmenopausal osteoporosis | 70 mg once weekly |
| Osteoporosis in men | 70 mg once weekly |
| Glucocorticoid-induced osteoporosis (prednisolone >5 mg/day >3 months) | 70 mg once weekly |
| Paget’s disease | 40 mg once daily for 6 months (specialist setting) |
Side effects
- Upper GI events — oesophagitis, gastritis, dyspepsia, abdominal pain (most common; reduced by strict upright administration)
- Musculoskeletal pain — mild-to-moderate diffuse bone or joint pain in some patients
- Acute phase reaction — flu-like symptoms with first dose, less common with weekly oral than IV zoledronate
- Hypocalcaemia — if vitamin D or calcium status was inadequate at start; correct deficiency first
- Osteonecrosis of the jaw (ONJ) — rare with oral bisphosphonate; risk < 1 in 10,000 in osteoporosis dosing (much higher in oncology IV doses)
- Atypical femoral fracture (AFF) — rare; risk increases with treatment duration >5 years; consider drug holiday after 5–7 years if low fracture risk
- Atrial fibrillation — weak signal in some studies; clinical relevance debated
Drug interactions
- Calcium, magnesium, iron, antacids, dairy, mineral water — reduce absorption; the 30–60 minute empty-stomach rule covers this
- NSAIDs — additive upper GI risk; use cautiously together, particularly with concurrent gastroprotection
- Aspirin — modest additive GI risk
- Levothyroxine — both compete for the empty-stomach window; arrange dosing schedule carefully
Contraindications
- Oesophageal stricture, achalasia, or other oesophageal abnormality
- Inability to stand or sit upright for 30–60 minutes
- Severe renal impairment (eGFR < 35 ml/min/1.73 m2)
- Hypocalcaemia (correct first)
- Pregnancy and lactation (limited data; bisphosphonates accumulate in fetal bone)
- Severe vitamin D deficiency (correct first)
Pre-treatment checklist
- Confirm 25-OH-D > 30 ng/ml (correct deficiency with Calcirol or Arachitol first)
- Confirm corrected calcium normal
- Confirm eGFR > 35
- Dental review — address any active dental work, consider extractions before starting (lower ONJ risk)
- Review duration plan — consider drug holiday at 5–7 years if fracture risk has improved
Storage
Store below 25°C in original packaging, protect from moisture.
Frequently Asked Questions
Why must I stay upright for 30 minutes?
Alendronate is severely irritating to oesophageal mucosa. Lying down risks tablet retention in the oesophagus, oesophagitis, and stricture. Standing or sitting upright lets gravity move the tablet down quickly. The 30-minute rule is non-negotiable — if you cannot follow it, alendronate is not the right drug for you.
Why empty stomach?
Bisphosphonate oral bioavailability is less than 1%. Any food or non-water beverage reduces absorption further to near zero, wasting the dose. Plain water only for 30–60 minutes after dosing.
What if I miss a dose?
Take the missed dose the next morning under the same rules, then continue on your usual day. Do NOT take two doses on the same day. If you miss several doses, simply restart on your chosen day.
How long do I take it for?
Initial course 5 years for postmenopausal osteoporosis with low fracture risk; 7–10 years for high fracture risk. After 5 years, reassess fracture risk and BMD: if risk has improved, consider a “drug holiday” of 1–2 years (alendronate continues to act on bone for years after stopping); if risk remains high, continue. The drug holiday concept reduces the rare risk of atypical femoral fracture.
What is osteonecrosis of the jaw?
A rare complication where bone exposes through the gum, fails to heal, and may become infected. Risk in oral osteoporosis dosing is < 1 in 10,000 per year. Risk factors: extensive dental work (extractions, implants), poor oral hygiene, glucocorticoid use, smoking. Have any dental work done BEFORE starting alendronate where possible.
What is atypical femoral fracture?
Subtrochanteric or femoral shaft fracture with characteristic X-ray features, often after minimal trauma, sometimes preceded by thigh or groin pain. Risk increases with treatment duration >5 years. The drug holiday concept addresses this. Report any new thigh or groin pain promptly.
Will it work if I keep eating with it?
No — you will essentially get no drug. Alendronate without strict empty-stomach administration is wasted.
Can I take vitamin D and calcium with it?
Yes — in fact you should. But take them at a different time of day. Topcal M or Cipcal at lunch and dinner; alendronate first thing in the morning on empty stomach. Calcium and alendronate together = no drug absorption.
What about IV zoledronate instead?
Zoledronic acid 5 mg IV once yearly is an excellent alternative for patients who cannot tolerate the oral administration rules, who have GI side effects, or who prefer once-yearly dosing. Trade-off: more pronounced acute-phase reaction with first dose (flu-like symptoms 24–48 hours), and slightly higher ONJ risk in oncology dosing (lower in osteoporosis dosing).
Is it safe in men?
Yes — alendronate is approved for osteoporosis in men with low BMD or fragility fracture. Dose and administration rules are the same.
Other Vitamins & Minerals
- Calcirol — cholecalciferol 60,000 IU sachet
- Alphadol — alfacalcidol for CKD-related deficiency
- Cipcal — calcium carbonate + multivitamins
- Topcal M — calcium + magnesium + vitamin D
- Arachitol 6L Injection — cholecalciferol IM depot
- Multivite Gold — comprehensive multivitamin
Medical Disclaimer
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Ranked by recent MedsBase order volume — what other customers in this category are picking.
| Strength | 70 mg |
|---|---|
| Quantity | 28 Tablet/s, 56 Tablet/s, 84 Tablet/s, 168 Tablet/s |
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Osteofos
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