Medication·Interactions & depletion·Reviewed June 9, 2026
Alendronate interactions.
Alendronate has 7 documented interactions in the NutriStack database. Prolonged use is also associated with lower Calcium. The full interaction list, depletion table, and replacement suggestions are below. None of this is a substitute for your prescriber's advice.
Alendronate at a glance.
A quick, data-grounded summary. The full tables are below.
Alendronate has 7 documented interactions in the NutriStack database. Prolonged use is also associated with lower Calcium. The full interaction list, depletion table, and replacement suggestions are below. None of this is a substitute for your prescriber's advice.
Substances that interact with alendronate.
Every supplement and medication in the NutriStack database with a documented interaction with this drug, highest-severity first. Open any pair for the mechanism and sources.
| Substance | Interaction | What happens |
|---|---|---|
| Calcium | Timing Sensitive | Calcium chelates alendronate and dramatically reduces its already-low bioavailability (0.6-0.7%). Taking calcium within 30 minutes of alendronate... details → |
| Iron | Timing Sensitive | Iron chelates alendronate in the GI tract, substantially reducing the already-poor oral absorption of this bisphosphonate. Given alendronate's... details → |
| Magnesium Glycinate | Timing Sensitive | Magnesium can chelate alendronate, reducing its absorption. While the interaction is similar in mechanism to calcium and iron, alendronate's... details → |
| Strontium | Timing Sensitive | Strontium is a divalent cation that can chelate bisphosphonates in the gut, blocking absorption. Strontium and bisphosphonates also compete for... details → |
| Zinc | Timing Sensitive | Zinc is a divalent cation that chelates alendronate in the gut, similar to the well-known calcium, iron, and magnesium interactions. Because... details → |
| Vitamin D3 | Synergy | Adequate vitamin D status is essential for alendronate to work properly. In a multi-year cohort, women whose 25(OH)D rose the most during and after... details → |
| Vitamin K2 | Synergy | Alendronate plus vitamin K2 produces greater suppression of undercarboxylated osteocalcin and modestly better bone outcomes than alendronate alone... details → |
What alendronate can deplete.
Nutrients this medication is associated with lowering over time, with the mechanism, a suggested replacement where one applies, and the biomarker to monitor. Discuss any replacement with your prescriber first.
| Nutrient | Severity | How it happens | Replace with | Monitor |
|---|---|---|---|---|
| Calcium | Moderate | Bisphosphonate suppression of bone resorption can lower serum calcium, especially when calcium intake, vitamin D status, or kidney function is poor. | Calcium | Serum calcium + 25-OH vitamin D |
The full alendronate profile.
Uses, typical dosing, side effects, and the cited evidence for this medication.
Common alendronate questions.
Quick answers drawn from the tables above.
What interacts with Alendronate?
In the NutriStack database, Alendronate has 7 documented interactions. The most notable include Calcium, Iron, Magnesium Glycinate, Strontium, and Zinc. Check any specific combination before taking it and confirm with your prescriber.
Does Alendronate deplete any nutrients?
Alendronate is associated with lowering Calcium with prolonged use. Useful biomarkers to monitor include Serum calcium + 25-OH vitamin D. Ask your prescriber before adding any replacement supplement.
Is it safe to take Calcium with Alendronate?
NutriStack classifies the Calcium and Alendronate pairing as timing sensitive: Calcium chelates alendronate and dramatically reduces its already-low bioavailability (0.6-0.7%). Taking calcium within 30 minutes of alendronate can render the... Take alendronate first thing in the morning with plain water, at least 30 minutes before any food, beverages, or supplements including calcium. Take... Always confirm with your prescriber.
Check your whole stack
See how alendronate fits your supplements.
NutriStack screens your full routine for interactions and depletions, and updates the moment you change it.