Short answer: For osteoporosis in postmenopausal women and in men, the Fosamax label dose is 70 mg once weekly or 10 mg once daily. The tablet is swallowed on getting up, with 6 to 8 ounces of plain water, at least 30 minutes before the first food, drink or other medicine, and without lying down for 30 minutes. A missed weekly dose is taken the next morning.
This is what the FDA label says. Follow your prescriber. Your prescriber may use a different dose or pace than the label's standard schedule.
What Fosamax is approved for: Fosamax is a bisphosphonate approved to treat and prevent osteoporosis in postmenopausal women, to increase bone mass in men with osteoporosis, to treat steroid (glucocorticoid)-induced osteoporosis in people taking the equivalent of 7.5 mg or more of prednisone a day with low bone density, and to treat Paget's disease of bone (sections 1.1 to 1.5). The label says the best length of use has not been set, and people at low fracture risk may be considered for stopping after 3 to 5 years (section 1.6).
Source
FOSAMAX (alendronate sodium) tablets, for oral use, prescribing information and Medication Guide. Organon. DailyMed, version published March 16, 2026. DailyMed setid 14e931fd-2c5f-4d90-b7db-5980706f4a56
Fosamax is taken on getting up for the day, swallowed whole with a full glass (6 to 8 ounces) of plain water only, at least half an hour before the first food, drink or other medicine. Other drinks, including mineral water, coffee, tea and juice, reduce absorption (section 2.6).
After a dose, the person does not lie down for at least 30 minutes and until after the first food of the day. Fosamax is not taken at bedtime or before getting up (section 2.6).
Only the 70 mg tablet is still marketed as Fosamax. The label notes that 5, 10, 35 and 40 mg alendronate tablets are available from other makers, and Fosamax oral solution is no longer marketed (sections 2, 3).
The table below is the label's schedule, from the Dosage and Administration section. Numbers are copied exactly; the section is in brackets.
| Use | Recommended dosage |
|---|---|
| Treatment of osteoporosis in postmenopausal women | One 70 mg tablet once weekly, or one 10 mg tablet once daily |
| Prevention of osteoporosis in postmenopausal women | One 35 mg tablet once weekly, or one 5 mg tablet once daily |
| Increase bone mass in men with osteoporosis | One 70 mg tablet once weekly, or one 10 mg tablet once daily |
| Glucocorticoid-induced osteoporosis | One 5 mg tablet once daily; one 10 mg tablet once daily for postmenopausal women not receiving estrogen |
| Paget's disease of bone | 40 mg once a day for six months; re-treatment may be considered after a six-month evaluation in patients who relapse |
Supplemental calcium is taken if dietary intake is not enough. People at higher risk of low vitamin D, such as those over 70, nursing-home bound or chronically ill, may need vitamin D. People on steroids should get enough calcium and vitamin D.
Calcium, antacids and other oral medicines with multivalent cations interfere with absorption, so other oral medicines are taken at least half an hour after Fosamax.
The best length of use has not been set. The need to continue is re-evaluated periodically, people at low fracture risk may be considered for stopping after 3 to 5 years, and fracture risk is re-checked periodically after stopping.
Fosamax is not recommended when creatinine clearance is under 35 mL/min. No dose change is needed for creatinine clearance of 35 to 60 mL/min.
Fosamax is stopped when pregnancy is recognized.
If a once-weekly dose is missed, one dose is taken on the morning after it is remembered. Two doses are not taken on the same day, and the person returns to one dose a week on the originally chosen day. The Medication Guide adds: do not take the missed dose later in the day.
More on this: missed a dose of Fosamax.
In Dose Track you set up Fosamax as a protocol with the dose and schedule your prescriber gave you. A protocol can hold dose steps, each with its own dose and length in days or weeks, so a step-up plan like the one on the label can be entered once and the app moves to the next step on its own. Reminders follow the schedule, and every dose is logged with the date and time, so you can see which step you are on and when your last dose was. The app follows what you enter; it does not choose or change a dose.
This page is what the FDA label says, in plain words. It is not medical advice. Follow your prescriber, and ask them or your pharmacist about anything here.