Reported Reactions

Drugs › Bisphosphonate

Generic name

Alendronate sodium: adverse event reports filed with FDA

18,082 reports list it as a suspect or interacting product, 2004–2026. Class: Bisphosphonate. Also reported as Alendronate Sodium Tablets, Alendronate Sodium Tablets Usp, Alendronate Sodium 70mg Tablet.

18,082
reports as suspect product
0.1% of all reports · about 804 a year
1,528
reports, 12 months to June 2026
1,889 in the 12 months before
90.4%
marked serious by the reporter
90.3% across the class
20.8%
record death among outcomes, as reported
3,770 reports · not verified by FDA

18,082 adverse event reports received by FDA list alendronate sodium, a generic name as a suspect or interacting product, from January 2004 to June 2026. A further 15,203 reports list it only as a concomitant medication, and those are not counted in the figures on this page.

In the 12 months to June 2026, 1,528 reports listed it, down 19% from 1,889 in the 12 months before. FDA releases FAERS data quarterly, so the newest months are incomplete and grow in later releases. Over its reporting history that is about 804 reports a year and 0.1% of the 20,646,523 reports in the database, and 18.6% of the reports for the bisphosphonate class. How many people take it is not in the data, so a count is not a rate of occurrence.

The MedDRA terms listed most often are pain (27.4%), femur fracture (26.8%) and fatigue (24.8%). A report can list several reactions, so shares add to more than 100%; 2,509 different terms appear across these reports. Pain is recorded in 27.4% of these reports, a larger share than in the median bisphosphonate drug (14.9%).

90.4% of the reports are marked serious by the reporter (90.3% across the class); 20.8% record death among the outcomes and 47.9% record hospitalisation, as reported. 41.7% of the reports came from other health professionals, and the largest patient age group is 18 to 44 (16.9%). FDA states that "a causal relationship cannot be established between product and reactions listed in a report" and that for any given report "there is no certainty that a suspected drug caused the event."

Reports by month, five years

0123245Jul 2021: 119Aug 2021: 87Sep 2021: 223Oct 2021: 182Nov 2021: 158Dec 2021: 1582022Jan 2022: 137Feb 2022: 79Mar 2022: 139Apr 2022: 159May 2022: 182Jun 2022: 186Jul 2022: 72Aug 2022: 98Sep 2022: 195Oct 2022: 144Nov 2022: 124Dec 2022: 652023Jan 2023: 104Feb 2023: 83Mar 2023: 69Apr 2023: 80May 2023: 65Jun 2023: 47Jul 2023: 45Aug 2023: 92Sep 2023: 208Oct 2023: 100Nov 2023: 116Dec 2023: 1292024Jan 2024: 102Feb 2024: 123Mar 2024: 130Apr 2024: 111May 2024: 177Jun 2024: 136Jul 2024: 206Aug 2024: 114Sep 2024: 245Oct 2024: 205Nov 2024: 152Dec 2024: 2042025Jan 2025: 113Feb 2025: 162Mar 2025: 168Apr 2025: 97May 2025: 54Jun 2025: 169Jul 2025: 178Aug 2025: 116Sep 2025: 228Oct 2025: 96Nov 2025: 106Dec 2025: 2042026Jan 2026: 95Feb 2026: 94Mar 2026: 72Apr 2026: 100May 2026: 72Jun 2026: 167

Reports by the month FDA received them. FDA releases FAERS data quarterly, so the newest months are incomplete and grow in later releases.

By year received

01,1862,3722004: 1620042005: 272006: 322007: 4020072008: 1742009: 3402010: 45320102011: 7532012: 2,3722013: 1,43520132014: 7732015: 5642016: 41220162017: 4252018: 4792019: 56420192020: 7202021: 1,5892022: 1,58020222023: 1,1382024: 1,9052025: 1,69120252026: 600

2026 covers reports received through June 2026 only.

Reactions recorded in the reports

share of Alendronate sodium reports recording the termmedian drug in bisphosphonate

  1. Painpain, site not specified27.4%4,960
  2. Femur fracture26.8%4,852
  3. Fatiguetiredness24.8%4,479
  4. Rheumatoid arthritisrheumatoid arthritis, an inflammatory joint disease23.1%4,179
  5. Drug ineffectivethe medicine did not work as expected23%4,167
  6. Arthralgiajoint pain22.8%4,127
  7. Abdominal discomfortstomach discomfort22.6%4,083
  8. Alopeciahair loss22%3,986
  9. Systemic lupus erythematosuslupus, an autoimmune disease21.7%3,916
  10. Pemphigus21.4%3,878
  11. Rashskin rash21.3%3,856
  12. Arthropathy20.8%3,758
  13. Glossodynia20.2%3,649
  14. Hand deformity19.4%3,502
  15. Swellingswelling19.1%3,459
  16. Infusion related reactiona reaction during or soon after an infusion18.6%3,358
  17. Wound18.2%3,292
  18. Hypertensionhigh blood pressure18.2%3,284
  19. Pericarditisinflammation of the sac around the heart17.6%3,184
  20. Synovitis17.4%3,139
  21. Joint swellinga swollen joint17.3%3,134
  22. Hypersensitivityan allergic-type reaction17.3%3,131
  23. Drug intolerancethe medicine was not tolerated16.9%3,058
  24. Hepatic enzyme increasedraised liver enzymes16.1%2,910
  25. Off label useused for a purpose or in a way not on the label16.1%2,906
  26. Discomfortdiscomfort15.7%2,832
  27. Maternal exposure during pregnancythe mother took the medicine during pregnancy15.4%2,786
  28. Condition aggravatedthe condition being treated got worse15.2%2,741

Top 30 of 2,509 MedDRA preferred terms recorded across these reports, with a plain-language gloss where one is available. One report can record several terms. The hollow bar is the median share across the 9 drugs in the bisphosphonate class; it describes the reports, not the patients. FDA states that adverse event reports "represent a small percentage of total usage numbers of a product", that "common products may have a higher number of adverse events due to the higher total number of people using the product", and that the data "by themselves are not an indicator of the safety profile of the drug or biologic."

Outcomes recorded

Death20.8%3,770
Life-threatening21.2%3,841
Hospitalisation (initial or prolonged)47.9%8,656
Disability37%6,695
Congenital anomaly9.7%1,761
Other serious79.6%14,389
Not serious9.6%1,733

Outcome flags as the reporter set them; a report can carry several, and "other serious" is FDA's own category for serious reports outside the named outcomes. Grey bar: all 97,060 reports in the class. FDA has not verified any outcome and states that the reports "cannot be used to estimate the incidence of these events."

Patients and reporters

Patient age

Under 20%5
2 to 110%2
12 to 170.1%19
18 to 4416.9%3,054
45 to 6414%2,523
65 to 749%1,636
75 and over10.4%1,889
Age not given49.5%8,954

Patient sex

Female80.8%14,616
Male5.9%1,058
Not given13.3%2,408

Who reported

Physician17.4%3,145
Pharmacist2.4%427
Other health professional41.7%7,541
Lawyer5.7%1,023
Consumer or non-health professional30.2%5,457
Not given2.7%489

Age and sex as stated in the report; the reporter's qualification is the primary source recorded by FDA. 41.9% of reports give the United States as the country of the event or reporter.

Reason for use recorded

Indication as recorded (MedDRA)ReportsShare
Rheumatoid arthritis4,83826.8%
Osteoporosis4,66425.8%
Osteopenia8294.6%
Osteoporosis prophylaxis3842.1%
Bone density decreased1360.8%
Osteoporosis postmenopausal1290.7%

The indication field is filled in by the reporter and is often blank; shares are of all 18,082 reports.

Drugs most often listed in the same reports

Drug (any role in the report)ReportsShare of Alendronate sodium reports
Fosamax7,55341.8%
Prednisone7,02338.8%
Methotrexate6,25934.6%
Folic acid6,20034.3%
Sulfasalazine5,79032%
Rituximab5,55830.7%
Orencia5,53730.6%
Enbrel5,43430.1%
Desoximetasone5,41630%
Cimzia5,40529.9%

Other products listed in reports where Alendronate sodium is a suspect product, whatever their own role. Co-listing means the two were recorded together; it says nothing about either product's part in the event. Only the 2,500 most-reported names are counted here.

In context

MeasureAlendronate sodiumBisphosphonateAll reports
Reports as suspect product18,08297,06020,646,523
Share of that pool—18.6%0.1%
Reports, latest 12 months1,528—1,332,454
Marked serious90.4%90.3%57.4%
Death recorded among outcomes, per 1,000 reports20813891
Hospitalisation recorded, per 1,000 reports479369213
Consumer-filed share30.2%28%45.8%
Top term, share of reportsPain 27.4%median 14.9%2.9%

Shares are of reports, not of patients treated. The number of people taking a product is not in the data, so none of these figures is a rate, and differences between columns reflect who takes a product, who reports and how long it has been sold. FDA states that adverse event reports "represent a small percentage of total usage numbers of a product", that "common products may have a higher number of adverse events due to the higher total number of people using the product", and that the data "by themselves are not an indicator of the safety profile of the drug or biologic."

Other drugs in the bisphosphonate class

DrugName typeReportsLatest 12 monthsMarked serious
Fosamaxbrand34,8441,31192.2%
Zoledronic acidgeneric16,6821,86897.1%
Reclastbrand10,38240281%
Actonelbrand6,0393384.3%
Alendronatebrand4,04521379.6%
Risedronate sodiumgeneric3,51255292.5%
Pamidronate disodiumgeneric2,1363296.9%
Ibandronate sodiumgeneric1,3386071.5%

Ordered by report count for navigation only. FDA states that adverse event reports "represent a small percentage of total usage numbers of a product", that "common products may have a higher number of adverse events due to the higher total number of people using the product", and that the data "by themselves are not an indicator of the safety profile of the drug or biologic." A brand and its generic are separate rows because reporters name them separately.

Questions about Alendronate sodium reports

How many adverse event reports has FDA received for Alendronate sodium?

18,082 reports list Alendronate sodium as a suspect or interacting product in the openFDA FAERS release of 28 Sep 2026, covering reports received through June 2026. 1,528 of them arrived in the latest 12 months. Another 15,203 list it only as a concomitant medication.

What reactions are recorded in Alendronate sodium reports?

pain (27.4%), femur fracture (26.8%), fatigue (24.8%), rheumatoid arthritis (23.1%) and drug ineffective (23%). These are MedDRA preferred terms coded from what the reporter described; a report can list several, and a term's presence is not a finding that Alendronate sodium was responsible.

How serious are the reports?

90.4% are marked serious by the reporter. Among the outcomes recorded, 20.8% of reports include death and 47.9% include hospitalisation. FDA has not verified these outcomes and states that the reports "cannot be used to estimate the incidence" of the events.

Who files these reports?

other health professional (41.7%), consumer or non-health professional (30.2%) and physician (17.4%). Most reports reach FDA through the manufacturer, which must forward reports it receives.

Are reports for Alendronate sodium rising?

1,528 reports in the 12 months to June 2026, down 19% from 1,889 in the 12 months before. FDA releases FAERS data quarterly, so the newest months are incomplete and grow in later releases. Counts also move with how many people take a product, its time on the market and publicity.

Do these reports show that Alendronate sodium was responsible for these reactions?

No. FDA states that "a causal relationship cannot be established between product and reactions listed in a report" and that for any given report "there is no certainty that a suspected drug caused the event." The reaction may relate to the condition being treated, to other medicines, or to something else.

Is this a list of the side effects of Alendronate sodium?

No. It is a count of what was reported to FDA. The adverse reactions observed in clinical studies are printed on the FDA-approved label, which a pharmacist or clinician can go through with you.

How do I report an adverse event?

Consumers and health professionals can report to FDA through MedWatch (Form FDA 3500 online, or 1-800-FDA-1088), or to the manufacturer, which must pass reports on. See the guide on how to report.

Where this comes from. Counts are built from the openFDA Drug Adverse Event (FAERS) bulk export released 28 Sep 2026, which holds reports FDA received through 30 Jun 2026. Drug names are as reported, resolved to the brand or generic name on the FDA label where openFDA's harmonisation matched them; classes are the pharmacologic class (EPC) from the label and the National Drug Code Directory of 17 Sep 2026. A report counts here when it lists Alendronate sodium as a suspect or interacting product; reports listing it only as a concomitant medication (15,203) are excluded. No report narrative, lot number, patient detail or reporter identity is published. See the methodology and sources; FDA's record is authoritative, and corrections are handled within five working days.

Drug data (FAERS) through 30 Jun 2026; device data (MAUDE) through 31 Aug 2026. Not medical advice.