Alendronic Acid SF Oral Solution

Osteoporosis affects an estimated three million people in the UK. It is a condition in which bones gradually lose their density and internal structure, making them more fragile and significantly more vulnerable to fracture. Many people are unaware they have osteoporosis until a break occurs, often after a minor fall or even a sudden movement. Alendronic Acid SF Oral Solution 70mg/100ml is a sugar-free, liquid formulation of alendronate, prescribed once weekly for the treatment and prevention of osteoporosis in adults who cannot tolerate or swallow the tablet form of alendronic acid.

Bone fractures associated with osteoporosis can be serious, particularly hip and vertebral fractures in older adults. Effective treatment can reduce fracture risk substantially. The liquid formulation is an important option for patients who have difficulty swallowing tablets, or who have experienced oesophageal side effects with the tablet form, ensuring that more patients can access appropriate bisphosphonate therapy.

Alendronic Acid SF Oral Solution is a liquid bisphosphonate medicine containing alendronic acid as the active ingredient, at a concentration equivalent to 70mg per 100ml. SF denotes that the formulation is sugar-free, making it appropriate for patients with diabetes or those who need to avoid sucrose.

The medicine is licensed in the UK for the treatment of osteoporosis in postmenopausal women and for the treatment of osteoporosis in men who are at increased risk of fracture. It is also licensed for the treatment of osteoporosis associated with glucocorticoid (steroid) therapy in adults.

Alendronic acid is the same active ingredient as that contained in the widely prescribed weekly alendronic acid 70mg tablet. The oral solution is bioequivalent to the tablet formulation in terms of the amount of active ingredient absorbed, and it is taken using the same once-weekly dosing schedule. It is prescribed for patients who require the liquid alternative, usually because the tablet formulation is not suitable for them.

This is a Prescription Only Medicine. It cannot be purchased without a valid prescription issued by a registered prescriber following a clinical consultation.

Bone is a living tissue that is constantly renewed. Specialised cells called osteoclasts break down old bone, while cells called osteoblasts build new bone to replace it. In osteoporosis, the balance between these two processes is disrupted. Osteoclasts break down bone faster than osteoblasts can rebuild it, resulting in a net loss of bone density over time.

Alendronic acid belongs to the bisphosphonate class of medicines. It works by binding strongly to bone mineral and inhibiting osteoclast activity. By reducing the rate at which osteoclasts break down bone tissue, alendronic acid slows or halts the ongoing bone loss associated with osteoporosis.

With sustained regular use, alendronic acid has been shown in clinical trials to increase bone mineral density at key fracture sites, including the spine and hip. This improvement in bone density is associated with a clinically meaningful reduction in the risk of fractures at these sites. The fracture prevention benefit builds over time and is dependent on consistent, ongoing use as prescribed.

The medicine does not rebuild bone that has already been lost. It stabilises and gradually improves the density of existing bone. For this reason, treatment is typically long term, and the prescriber will periodically review the ongoing clinical need and benefit.

Alendronic Acid SF Oral Solution must be taken on a strictly empty stomach, first thing in the morning, before any food, drink other than plain water, or other medicines. This is because food and most beverages significantly reduce the absorption of alendronic acid into the body.

Take the full 100ml dose. Drink the solution after rising for the day and while still in an upright position. Immediately after taking the solution, drink at least half a glass of plain tap water (approximately 120ml or more). Do not use mineral water, as this may reduce absorption.

Remain upright – either standing or sitting – for at least thirty minutes after taking the dose. Do not lie down during this period. Lying down too soon after taking alendronic acid significantly increases the risk of oesophageal irritation and ulceration. For the same reason, do not take the solution at bedtime or before getting up for the day.

Wait at least thirty minutes after taking the solution before eating, drinking anything other than plain water, or taking any other oral medicines or supplements.

Take the solution once weekly, on the same day each week. Choose a day that fits naturally into your routine and stick to it consistently. If you miss a dose, take it on the morning of the next day you remember. Do not take two doses on the same day and do not take a dose later in the day.

Licensed Formulation

Alendronic Acid SF Oral Solution is available in a single licensed strength and formulation in the UK.

Calcium and Vitamin D Supplementation

Many patients prescribed alendronic acid for osteoporosis will also be advised to take calcium and vitamin D supplements. These support the bone-strengthening effect of bisphosphonate therapy by ensuring the body has adequate building blocks for bone mineralisation. Supplements must not be taken at the same time as alendronic acid; they should be taken at a different time of day, at least thirty minutes after the weekly dose.

Your prescriber will advise whether supplementation is appropriate for you based on your dietary intake and individual clinical circumstances.

Always follow your prescriber's instructions regarding dosage, supplementation, and the duration of treatment. Do not alter your dosing schedule without first consulting your prescriber.

Like all medicines, Alendronic Acid SF Oral Solution can cause side effects. Many patients tolerate the medicine well. Adherence to the correct administration technique – particularly remaining upright for thirty minutes and taking the dose with sufficient water on an empty stomach – reduces the risk of oesophageal side effects considerably.

Common Side Effects (may affect up to 1 in 10 people)

1. Heartburn or acid reflux
2. Difficulty swallowing or pain on swallowing
3. Abdominal pain or discomfort
4. Nausea
5. Diarrhoea or constipation
6. Flatulence
7. Musculoskeletal pain, including bone, joint, or muscle pain
8. Headache

Uncommon Side Effects (may affect up to 1 in 100 people)

1. Oesophageal ulceration or erosion
2. Gastric or duodenal ulceration
3. Skin rash, redness, or itching
4. Low blood calcium levels (hypocalcaemia) – more likely in those with vitamin D deficiency

Rare but Serious Side Effects – Seek Medical Attention Promptly

The following serious adverse effects have been reported with bisphosphonate therapy, including alendronic acid. They are uncommon, but patients should be aware of them and seek medical advice if they occur.

1. Osteonecrosis of the jaw (ONJ): rare deterioration of jaw bone, particularly associated with dental procedures. Inform your dentist that you are taking a bisphosphonate before undergoing dental work.
2. Atypical femoral fractures: unusual fractures of the thigh bone associated with long-term bisphosphonate use. Report any new thigh, hip, or groin pain to your prescriber.
3. Severe skin reactions such as Stevens-Johnson syndrome (rare)
4. Severe musculoskeletal pain

Report any side effects directly to the MHRA via the Yellow Card scheme at yellowcard.mhra.gov.uk, or through your prescriber or pharmacist.

Suitable Patients

Alendronic Acid SF Oral Solution is licensed for use in adults with osteoporosis, including postmenopausal women, men at increased risk of fracture, and adults receiving long-term glucocorticoid therapy. It is particularly appropriate for patients who cannot tolerate or swallow the tablet formulation of alendronic acid, or who have experienced oesophageal adverse effects with the tablet form.

A prescriber will assess your bone health history, fracture risk, relevant medical conditions, and current medications before determining whether this treatment is appropriate for you.

Who Should Not Take Alendronic Acid SF Oral Solution

This medicine is not suitable for patients with any of the following conditions.

1. Abnormalities of the oesophagus that delay oesophageal emptying, such as stricture or achalasia
2. Inability to stand or sit upright for at least thirty minutes
3. Low blood calcium levels (hypocalcaemia) that have not been corrected
4. Severe kidney impairment (creatinine clearance below 35ml per minute)
5. Known hypersensitivity to alendronic acid or any excipient in the formulation

Patients with active upper gastrointestinal problems, including oesophagitis, gastric ulcers, or duodenitis, should inform their prescriber, as these conditions may be a contraindication or require careful assessment before commencing treatment.

Alendronic acid is not licensed for use in children or adolescents. Patients with significant kidney impairment should be assessed carefully, as dose adjustment or an alternative therapy may be necessary.

Alendronic Acid SF Oral Solution is a Prescription Only Medicine. The clinical consultation is the primary and essential step in the prescribing process. A prescription is a possible outcome of that consultation, not a guaranteed one. A prescription will only be issued if a registered prescriber determines that this treatment is clinically appropriate for your individual circumstances.

During your consultation with Pharmacy Planet, you will be asked to provide information about your diagnosis, your bone health history, any previous fractures, relevant medical conditions, and current medicines. This information is reviewed by a UK registered prescriber.

Bisphosphonate therapy for osteoporosis is typically initiated or overseen by a GP or specialist following formal diagnosis, which often involves a DEXA scan (a type of bone density scan). If you are transferring an existing prescription to Pharmacy Planet for ongoing supply, your prescriber will confirm that continued treatment is appropriate.

If your prescriber considers Alendronic Acid SF Oral Solution clinically appropriate, a prescription will be issued and your medicine dispensed by our GPhC-registered pharmacy. If the prescriber has concerns or requires further information, you will be informed and may be referred back to your GP or specialist for additional assessment.

Store Alendronic Acid SF Oral Solution below 25 degrees Celsius. Do not freeze. Keep the product in its original bottle with the cap closed tightly. Refer to the product packaging for the in-use stability period after first opening.

Keep this medicine out of the reach and sight of children. Do not use the solution after the expiry date printed on the label or carton. The expiry date refers to the last day of that month.

Do not dispose of medicines via household waste or wastewater. Return unused or out-of-date medicine to your pharmacist for safe disposal in line with UK environmental guidance.

All seven medicines listed below are oral tablets or capsules prescribed for osteoporosis, the same therapeutic category and the same form factor, making direct comparison appropriate. They differ in their active ingredient, dosing frequency, licensed indication, and mechanism of action.

The table below compares commonly prescribed oral bisphosphonate treatments available through Pharmacy Planet's osteoporosis service. Products are listed in order of dosing frequency, from daily to monthly, so you can quickly identify how each medicine fits into a patient's routine.

Important: This comparison is for general information only and does not replace medical advice. A prescriber will decide which treatment is suitable for you following an online consultation. All medicines listed are Prescription Only Medicines (POMs). Suitability depends on individual clinical circumstances including diagnosis, renal function, medical history, and concurrent medicines.

Pharmacy Planet is a GPhC-registered online pharmacy providing safe, compliant, and accessible prescription medicines to patients across the UK. Our dispensing and clinical processes are aligned with NHS guidance and GPhC standards for online pharmacy practice.

We understand that managing a long-term condition such as osteoporosis involves regular prescriptions and consistent access to medication. Our consultation service is designed to be straightforward and respectful of your time, with all prescriptions reviewed by UK registered prescribers.

Your privacy and the accuracy of your medication are our priorities. Every dispensed medicine is checked by a qualified pharmacist before dispatch, and our team is available to answer clinical questions about your treatment and to support you throughout your care.

1. electronic Medicines Compendium (emc). Alendronic Acid SF Oral Solution 70mg/100ml – Summary of Product Characteristics. www.medicines.org.uk/emc. Accessed June 2026.
2. British National Formulary (BNF). Alendronic acid. bnf.nice.org.uk/drugs/alendronic-acid. Accessed June 2026.
3. NHS. Alendronic acid. www.nhs.uk/medicines/alendronic-acid. Accessed June 2026.
4. National Osteoporosis Guideline Group (NOGG). Clinical Guideline for the Prevention and Treatment of Osteoporosis. www.nogg.org.uk. Accessed June 2026.
5. NICE. Osteoporosis: assessing the risk of fragility fracture. Clinical guideline CG146. www.nice.org.uk/guidance/cg146. Accessed June 2026.