What is a typical dosing schedule for oral alendronate?

• A. 70 mg once weekly or 10 mg daily; take with a full glass of water on an empty stomach; remain upright for 30–60 minutes.
• B. 5 mg monthly with meals.
• C. 25 mg daily with dairy.
• D. 100 mg weekly with juice.

Answer: (A)

Oral alendronate is a bisphosphonate that has very limited absorption if taken with food or beverages, so it must be swallowed with a full glass of plain water first thing in the morning on an empty stomach and you should stay upright for at least 30 minutes afterward to protect the esophagus. The standard dosing is either 70 mg once weekly or 10 mg daily, which provides effective suppression of bone resorption while minimizing irritation. The other options prescribe dosing or administration that would reduce absorption or increase risk—taking with meals, dairy, or juice, or using nonstandard schedules like monthly dosing or a higher weekly dose—none of these align with how alendronate is recommended to be taken.