The common adverse effects of Fosamax are abdominal pain, dyspepsia, diarrhoea, constipation, oesophagitis, peptic ulceration, osteonecrosis of the jaw, bone/joint/muscle pain, hypocalcaemia and nausea. These side effects are not seen in all patients and seen in long term use. These side effects are not permanent and usually resolve after stopping Fosamax. With proper precautions these side effects can be avoided. Advice 1. Continue Fosamax 2. Take Fosamx on an empty stomach. Take with a full glass of plain water at least ½ hour before the 1st food/drink/medication of the day & remain in sitting/upright position for at least ½ hour. Swallow whole, do not chew/crush 3. Take rest and avoid strenuous physical activity 4. Take over the counter calcium and vitamin D supplement 5. Drink 4 – 5 liters of water daily 6. Get dental check up every year as Fosamax causes osteonecrosis of jaw and maintain a very good dental hygiene 7. Take high protein and calcium diet such as milk, dry fruits, eggs, cheese, fruits pulses, and chicken 8. Investigations c. Serum calcium d. Serum vitamin D I hope this information will help you. I will be happy if you ask another question Thank