12 Foods To Avoid While Taking Fosamax

Foods To Avoid While Taking Fosamax

Fosamax, also known as Alendronate, is commonly prescribed to people suffering from osteoporosis.

Osteoporosis, a common bone disease, can lead to fractures. Recent statistics from the International Osteoporosis Foundation reveal that globally, approximately 1 in 3 women aged 50 and above and 1 in 5 men will experience osteoporotic fractures within their lifetime.(1)

Proper nutrition plays a significant role in reducing the risk of osteoporosis.
This article aims to provide a detailed list of 12 foods to avoid while taking Fosamax, which helps you maximize the medicine’s benefits and minimize any negative interactions.

We’ll guide you through this topic with a conversational, informative approach to make sure you have the best guidance on your journey towards healthier bones.

Fosamax is a brand name for the medication Alendronate, a type of drug known as bisphosphonate (bis FOS fo nayt). The main function of this medication is to increase our bone density which makes bones stronger and less likely to fracture.

It slows down the process of bone resorption, in which bone tissue is broken down and the minerals, like calcium, are moved from the bone into the blood.

Fosamax is often prescribed to those who are diagnosed with conditions such as osteoporosis or Paget’s disease, which are characterized by fragile and easily broken bones.

It also used by women to treat or prevent osteoporosis caused by menopause.

Warnings while taking Fosamax

Fosamax can cause some serious issues in the stomach or esophagus. Stop taking it and call your doctor if you experience any chest pain, new or worsening heartburn, or pain while swallowing.

It is not suitable for those with severe kidney disease. Always show your complete medical history to your doctor before starting on this medication.

Ensure your blood calcium levels are normal before starting Fosamax. This drug may worsen low calcium levels and may cause severe muscle, nerve, and bone problems.

In some cases, this medication can result in jaw bone loss (osteonecrosis) or a fracture in the leg bone known as a femur fracture.

Signs of osteonecrosis may include:

  • red or swollen gums
  • jaw pain or numbness
  • loose teeth
  • delayed healing after dental work

Symptoms of a femur fracture may include pain in the leg or groin area.

Related: 10 Foods To Avoid When Taking Naproxen

What are the worst side effects of Fosamax?

It’s important to note that not everyone who takes Fosamax will experience these, but it is still crucial to be aware of them. Here are some of the most common side effects:

  • heartburn, upset stomach, nausea, or diarrhea
  • severe bone, joint, or muscle pain
  • Dizziness or vertigo
  • inflammation in the eyes, leading to pain.

In some rare cases, Fosamax could also cause more severe side effects that require immediate medical attention:

  • severe jaw pain, swelling, numbness, loose teeth, or a slow healing process after dental work.
  • Unusual thigh bone fractures which include new or unusual pain in the hip or thigh.
  • Mouth ulcers
  • Skin blisters
  • Sunlight-sensitive rash
  • Esophagus problems like chest pain, trouble swallowing, or a feeling of food stuck in the throat.

According to the FDA, people taking Fosamax may experience severe bone, muscle, and joint pains, whether it be days, months, or even years after starting the medication. (2)

Connection between foods and Fosamax

Food plays an important role when it comes to medication, and Fosamax is no exception. Certain types of foods and beverages can greatly affect the effectiveness of Fosamax.

The main reason is that Fosamax needs an acidic stomach environment to be properly absorbed. Some foods and drinks can increase the pH of your stomach which makes it less acidic and hinders the medication’s absorption.

To ensure effective absorption, it’s recommended that you take Fosamax on an empty stomach first thing in the morning, at least 30 to 60 minutes before your first meal, drink, or other medication of the day. Plus, it’s important to remain upright for at least 30 minutes after taking Fosamax to avoid its potential to cause esophageal irritation.

Related: 12 Foods You Must Avoid When Taking Hydroxyurea

12 foods to avoid while taking Fosamax

12 Foods To Avoid While Taking Fosamax

Let’s now explore the details of which foods to avoid while taking Fosamax to ensure maximum absorption and effectiveness of the medication. 

1) Calcium-Rich Foods

Calcium-rich foods, like dairy products (milk, cheese, yogurt), tofu, and fortified cereals, can reduce the effectiveness of Fosamax. The reason behind this interaction is that Fosamax binds with calcium in the stomach, which prevents it from being absorbed into the body.

Therefore, while calcium is essential for bone health, it’s good for you to consume these foods at least 30 to 60 minutes after taking Fosamax.

2) Caffeinated Beverages

Caffeinated beverages like coffee, tea, and some soft drinks can also interfere with Fosamax absorption. So avoid these to consume until at least a half-hour after taking the medication.

The caffeine present in these drinks stimulates the production of stomach acid, which can affect the absorption of Fosamax when consumed too close to the time of medication administration.

3) Fruit Juices

Fruit juices, especially those rich in calcium, like orange or grapefruit juice, can interfere with the absorption of Fosamax. These juices increase the pH of the stomach and make it less acidic, hindering Fosamax’s absorption.

It’s advised to avoid drinking fruit juices until you’ve waited the recommended 30 to 60 minutes after taking Fosamax.

Related: Vitamin D Magnesium and Turmeric Lemonade Health Benefits

4) High-Fiber Foods

According to Harvard Health, if there is both fiber and medication in the intestine, the medication may get carried away with the fiber and be excreted instead of being fully absorbed.

Foods like whole grains, peas, beans, lentils, nuts, and seeds have a large amount of fiber and can interfere with the absorption of Fosamax. The high fiber content binds with the medication in the stomach, preventing it from being fully absorbed. Therefore, avoid consuming these high-fiber foods until after the recommended waiting period after taking Fosamax.

5) Sparkling Water

Water is generally recommended when taking any medication but sparkling water is an exception when it comes to Fosamax. The carbonation in sparkling water can increase the pH levels in the stomach, making it less acidic.

This can interfere with the absorption of Fosamax, leading to decreased effectiveness of the medication. Therefore, it’s best to stick with still water that is room temperature or warm when swallowing your Fosamax pill.

6) Alcohol

Alcohol must be avoided when taking Fosamax. It can irritate your stomach and make it more difficult for Fosamax to work effectively. Heavy drinking can also cause bone loss, which is counterproductive when taking a medication designed to strengthen bones.

7) Iron Supplements

Iron supplements can have a negative effect on the absorption of Fosamax. Iron can bind with Fosamax in your digestive tract, which can hinder its absorption and make the medication less effective.

We recommend you take iron supplements at a different time of day than Fosamax to avoid this interaction.

8) Soda

Just like sparkling water, soda can interfere with the absorption of Fosamax. It is usually high in phosphoric acid, which can change your stomach’s acidity levels and hinder the medication’s effectiveness.

According to the American Journal of Clinical Nutrition high phosphorus intake, primarily from sodas, can cause lower bone density (3). Having low bone density can lead to some serious medical issues that might result in bone fractures. It’s best to avoid soda, especially around the time you take your medication.

9) High-Sodium Foods

Consuming high-sodium foods can reduce calcium levels. It happens because our body starts to release more calcium through urine.

Since salt is a common ingredient in many products, make sure to check the nutrition label first to avoid accidentally consuming too much sodium.

High-sodium foods that you should avoid while taking Fosamax are processed and pre-packaged snacks like chips, crackers, pretzels, beef jerky, fast food, and canned foods.

Plus, eating too much sodium can harm your bones. Some studies suggest that high sodium intake is linked to increased bone fragility (a silent condition that increases the risk of bone fractures).

Related: Do Pretzels Cause Constipation? Uncover this Sweet treat

10) Acidic Foods

Highly acidic foods like tomatoes, citrus fruits, vinegar, and soft drinks can increase stomach acid and make Fosamax less effective.

These foods change the pH balance in the stomach, which can impact how well Fosamax is absorbed. As Fosamax requires a highly acidic environment to be properly absorbed into the bloodstream but consuming these foods around the time of taking the medication can hinder its effectiveness.

11) Calcium-Fortified Foods

Calcium-fortified foods, like certain types of bread and juices, can also impact the effectiveness of Fosamax. They also increase the pH of the stomach, which interferes with Fosamax absorption.

It doesn’t really mess with Fosamax, but it’s good to avoid calcium-fortified foods close to the time of taking Fosamax. Keep in mind, that while calcium is vital for bone health, its consumption should be appropriately timed to ensure that Fosamax is absorbed fully and works effectively.

12) Licorice

Licorice, especially the black variety, can be problematic when taking Fosamax. It contains a compound called glycyrrhizin, which can cause your body to excrete more calcium and potassium. This loss of essential minerals can lead to weaker bones over time.

Glycyrrhizin can also increase the acidity in your stomach, which can interfere with the absorption of Fosamax. Therefore, it is advisable to limit your intake of licorice while taking Fosamax, especially around the time of medication intake.

Remember, the goal is to ensure that Fosamax can work as effectively as possible to help strengthen your bones.

What foods to eat when on Fosamax?

By improving bone health, the foods listed below can help in reducing the risk of osteoporosis while using Fosamax:

1) Low-Fiber Foods

Opt for low-fiber foods immediately after taking Fosamax as they allow for better absorption of the medication. Foods like tender meat, refined pasta, fish and poultry, ham, bacon, shellfish, lunch meat, and peeled fruits are excellent choices. These foods do not bind with the medication, ensuring that it is adequately absorbed.

2) High Protein Foods

Including protein-rich foods in your daily diet can help promote bone health. Lean meats(lamb, veal, pork, kangaroo), fish, eggs, and dairy products(milk, yogurt, and cheese) are rich in protein and also contain other essential nutrients for bone health like calcium and vitamin D.

3) Fruits and Vegetables

If you wanna have good bone health, make sure to include a mix of fruits and veggies in your diet. They are packed with vitamins and minerals like (vitamin C, vitamin E, magnesium, zinc, and phosphorous) that can help maintain bone health. Leafy green vegetables like spinach, kale, and broccoli are high in calcium, which is beneficial for bone strength.

4) Dairy products

Dairy products such as milk, cheese(especially cottage cheese), and yogurt(especially Greek yogurt) are rich in calcium, which is crucial for bone health. They can be consumed a few hours after taking Fosamax to avoid interfering with the absorption of the medication.

5) Vitamin D Rich Foods

Foods rich in Vitamin D are good for people taking Fosamax as Vitamin D aids in the absorption of calcium, promoting stronger bones. Include fatty fish like salmon, mackerel, and tuna in your diet. Eggs, particularly the yolk, and fortified foods like cereal and orange juice are also excellent sources of vitamin D.

6) Whole Grains

Finally, whole grains like brown rice and oatmeal are packed with nutrients including magnesium. This makes them a great choice for maintaining healthy bones. Similar to dairy products, they should be consumed a few hours after taking Fosamax to avoid any interference with the medication’s absorption.

Who should not take Fosamax?

Fosamax should not be taken under certain conditions. These include:

  • People with abnormalities in the esophagus, such as difficulty in swallowing, esophageal ulcers, or narrowing of the esophagus, should avoid taking Fosamax.
  • Hypocalcemia is a condition in which the calcium levels in the body are too low. Fosamax should not be prescribed until the calcium levels are corrected.
  • People with severe kidney disease or bad kidney function should avoid taking Fosamax.
  • If you can’t stay in an upright position for at least 30 minutes, it’s best not to take Fosamax. Remember, you need to take it while standing or sitting upright.
  • Pregnant or nursing women should also avoid it as it may harm the baby.
  • If you’re scheduled for dental surgery or tooth extraction, inform your dentist that you’re taking Fosamax as it can affect bone healing.

When in doubt, talk to your doctor about taking Fosamax.

Other interactions with Fosamax

Fosamax can interact with certain other medicines, which can either interfere with its effectiveness or lead to harmful side effects. This includes:

  • Fosamax And Alcohol: Alcohol consumption can increase the risk of stomach irritation, nausea, esophageal ulcers, and other gastrointestinal side effects while taking Fosamax. It also reduces its absorption in the body. So it’s best to avoid alcohol completely or limit your intake while on Fosamax.
  • Aspirin and Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Fosamax can increase the risk of stomach and esophageal irritation. So, if you’re taking aspirin or NSAIDs, like ibuprofen, it might increase the risk of gastrointestinal side effects.
  • Before sleeping: Fosamax can increase the chances of acid reflux and heartburn. Taking this at bedtime or before lying down can lead to irritation of the esophagus. It’s best to take it in an upright position and wait for 30 minutes before lying down.
  • Antibiotics: Some antibiotics, like doxycycline and tetracycline, can interact negatively with Fosamax. It’s advisable to keep a gap of at least two hours before or after taking these antibiotics.

It’s good for you to share all the medicines you are currently taking, including prescription, over-the-counter, vitamins, and herbal supplements, with your doctor before taking Fosamax.

Is there a safer alternative to Fosamax?

If you’re looking for alternatives there are many other treatments that might be considered safer, depending on individual health conditions. These alternatives include:

  1. Bisphosphonates: Apart from Fosamax (Alendronate), there are other bisphosphonates like Actonel (Risedronate), Boniva (Ibandronate), and Reclast (Zoledronic Acid). These work similarly to Fosamax in slowing bone loss and increasing bone density.
  2. Selective Estrogen Receptor Modulators (SERMs): Evista (Raloxifene) is an example of a SERM that works by imitating the positive impact of estrogen on bone density in women after menopause, without some of the risks associated with estrogen.
  3. Parathyroid Hormone Therapy: Drugs like Forteo (Teriparatide) and Tymlos (Abaloparatide) works great by stimulating new bone growth, and are usually prescribed for those with a high risk of fractures.
  4. RANK Ligand Inhibitor: Prolia (Denosumab) is a type of medication that works by stopping the development of osteoclasts, cells that break down bone tissue. By doing so, it helps maintain stronger and healthier bones.
  5. Hormone Therapy: Hormone replacement therapy (HRT) can help maintain bone density, but this method is not recommended for the long-term use due to increased risks of blood clots, heart disease, and some cancers.

Always consult with your doctor before considering an alternative to Fosamax.


Fosamax can play a good role in managing osteoporosis, but it’s important to be mindful of specific conditions and foods to avoid while taking Fosamax that can interact badly with this medication. Being aware of dietary considerations, like avoiding certain vitamins and minerals for a few hours after taking the medication can help maximize its effectiveness.

Also, some individuals and those with specific health conditions should avoid Fosamax. Alternatives are available for those who cannot take Fosamax, and as always, it’s good to talk with your doctor about any concerns or questions.


Should I take Fosamax with food?

No, Fosamax should be taken on an empty stomach, at least 30 minutes before your first meal, drink, or medication of the day. Fosamax is effective only if you take it on an empty stomach to ensure maximum absorption and effectiveness. It is also recommended to drink a full glass of plain water with it and not lie down for at least 30 minutes after taking Fosamax.

Can you exercise after taking Fosamax?

Yes, you can exercise after taking Fosamax, but it’s good to wait at least 30 minutes after ingesting the medication before you start to exercise. But you can do light activities before consuming your first food or beverage (excluding plain water).

This waiting period ensures that the total dose has been absorbed into your system. This is because some exercise, like bending over or lying down, can cause Fosamax to leak back into the esophagus, which can lead to irritation or damage.

It’s best to drink a full glass of water after taking Fosamax before exercising to ensure adequate hydration and better absorption.

Can I take Fosamax in the afternoon?

Yes, can take it in the afternoon, but make sure to follow the guideline of taking it on an empty stomach and waiting 30 minutes before lying down or eating. It’s usually taken in the morning once a week but If it’s not possible, you can take it at another time of the day.

How long after taking Fosamax can I drink coffee?

You should wait a minimum of 30 minutes after taking Fosamax before consuming coffee. This is because coffee, like any other beverage or food, can interfere with the absorption of Fosamax in your body. For the best results, take the medication on an empty stomach with a full glass of water. Wait for 30 minutes before eating, drinking, or taking other medications.

How long after eating can you take Fosamax?

You should wait at least 30 minutes to 2 hours after eating to take Fosamax. The drug is best absorbed on an empty stomach, and eating could decrease its effectiveness. Taking the drug with a meal or soon after a meal may decrease the amount of drug that gets into your body.

Why is alendronate taken once a week?

Alendronate is usually taken once a week because it stays in the body for a long time and continues to affect the bones. This long-lasting effect allows for less frequent dosing. After you take the medication, it gets absorbed by the cells in your bones. Then, the drug helps to slow down the process of bone breakdown, which makes your bones stronger and lowers the chances of getting fractures.

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The information provided in this article is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Don’t ignore professional medical advice or put off seeking it just because of something you read here. Although we aim to offer precise and current information, we do not guarantee its completeness, accuracy, reliability, suitability, or availability for any purpose. Using the information in this document is at your own risk. We are not responsible for any losses or damages caused by our content.

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