Last reviewed 2026-04-22 · How we verify

Alendronate sodium hydrate

Alendronate sodium inhibits osteoclast-mediated bone resorption by binding to hydroxyapatite on the bone surface and blocking farnesyl pyrophosphate synthase in the mevalonate pathway.

Alendronate sodium inhibits osteoclast-mediated bone resorption by binding to hydroxyapatite on the bone surface and blocking farnesyl pyrophosphate synthase in the mevalonate pathway. Used for Osteoporosis in postmenopausal women, Osteoporosis in men, Glucocorticoid-induced osteoporosis.

At a glance

Mechanism of action

As a bisphosphonate, alendronate is selectively taken up by osteoclasts during bone resorption and inhibits farnesyl pyrophosphate synthase, disrupting the prenylation of small GTPases required for osteoclast function and survival. This leads to decreased bone turnover and increased bone mineral density, making it effective for conditions characterized by excessive bone loss.

Approved indications

• Osteoporosis in postmenopausal women
• Osteoporosis in men
• Glucocorticoid-induced osteoporosis
• Paget's disease of bone

Common side effects

• Gastrointestinal upset (nausea, dyspepsia, abdominal pain)
• Musculoskeletal pain
• Headache
• Esophageal irritation / ulceration
• Osteonecrosis of the jaw (rare, long-term use)

Key clinical trials

• Denosumab Fracture Intervention Randomized Placebo Controlled Trial in Japanese Patients With Osteoporosis (PHASE3)

Primary sources

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