Alendronate and cholecalciferol (oral route)

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Use of alendronate and cholecalciferol combination is not indicated in children.

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of alendronate and cholecalciferol combination in the elderly.

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Erdafitinib
• Fosphenytoin
• Parathyroid Hormone
• Phenytoin

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

• Dairy Food

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Anemia or
• Blood clotting problems or
• Cancer or
• Dental or tooth problems or
• Dental procedures (eg, dental implants, tooth extraction) or
• Infection or
• Poor oral hygiene or
• Surgery (eg, dental surgery)—May increase risk for severe jaw problems.

• Blood or bone marrow problems (eg, leukemia, lymphoma, sarcoidosis)—Use with caution. May cause changes in vitamin D.

• Esophagus (the tube that runs from your throat to your stomach) problems (eg, achalasia, stricture) or
• Hypocalcemia (low calcium in the blood) or
• Inability to stand or sit upright for at least 30 minutes or
• Kidney disease, severe or
• Trouble with swallowing—Should not be used in patients with these conditions.

• Stomach or bowel problems (eg, Barrett's esophagus, duodenitis, gastritis, heartburn, inflammation of the esophagus, or ulcers)—Use with caution. May make these conditions worse.

• Vitamin D deficiency—Should be treated first before using this medicine.

Less common

• Chest pain, discomfort, or burning
• difficulty with swallowing
• heartburn
• muscle or bone pain
• pain with swallowing
• vomiting blood

Rare

• Abdominal or stomach cramps
• blistering, peeling, or loosening of the skin
• bloating or swelling of the face, arms, hands, lower legs, or feet
• chills
• confusion
• convulsions
• cough
• diarrhea
• difficulty with breathing
• fever
• irregular heartbeats
• itching
• joint pain
• large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
• mood or mental changes
• muscle cramps in the hands, arms, feet, legs, or face
• numbness and tingling around the mouth, fingertips, or feet
• rapid weight gain
• red skin lesions, often with a purple center
• red, irritated eyes
• shortness of breath
• sore throat
• sores, ulcers, or white spots in the mouth or on the lips
• swelling of the neck
• tremor
• unusual tiredness or weakness
• unusual weight gain or loss
• vomiting

Incidence not known

• Burning upper abdominal or stomach pain
• difficulty with moving
• heavy jaw feeling
• loosening of a tooth
• loss of appetite
• muscle aching or cramping
• muscle pains or stiffness
• pain or burning in the throat
• pain, swelling, or numbness in the mouth or jaw
• severe bone, joint, or muscle pain
• stomach bloating, burning, cramping, or pain
• swollen joints
• weight loss

Less common

• Acid or sour stomach
• belching
• constipation
• excess air or gas in the stomach or intestines
• full feeling
• headache
• indigestion
• passing gas
• pressure in the stomach
• stomach discomfort, upset, or pain
• swelling of the abdominal or stomach area

Rare

• Blurred vision or other change in vision
• decreased vision
• eye pain
• eye redness
• eye tenderness
• flushing or redness of the skin
• increased tearing
• rash
• redness of the eye
• sensitivity of the eye to light
• severe eye pain
• tearing
• unusually warm skin

Incidence not known

• Dizziness or lightheadedness
• feeling of constant movement of self or surroundings
• general feeling of discomfort or illness
• hair loss
• hives or welts
• lack or loss of strength
• sensation of spinning
• thinning of the hair