Hello, After intake of Fosamax, you may develop esophagitis, oesophagal pain, ulcers formation etc. Take the medicine on an empty stomach. It should be taken as soon as you get out of bed in the morning and at least 30 minutes before any food, beverage, or other medicines. Food and beverages (eg, mineral water, coffee, tea, or juice) will decrease the amount of alendronate absorbed by the body. Waiting longer than 30 minutes will allow more of the drug to be absorbed. Medicines such as antacids, calcium, or vitamin supplements will also decrease the absorption of alendronate. If you are using alendronate oral liquid, drink at least 2 ounces (a quarter of a cup) of water immediately after taking the medicine. This will allow the medicine to reach your intestines and be absorbed by the body more quickly. Swallow the tablet whole with a full glass (6 to 8 ounces) of plain water. Do not suck or chew on the tablet because it may cause throat irritation. If you are taking alendronate effervescent tablet, dissolve it in 4 ounces of room temperature plain water only (not mineral water or flavoured water). Wait at least 5 minutes after the effervescence stops and then stir the solution for 10 seconds and drink it. Do not lie down for at least 30 minutes after taking alendronate and before having your first food for the day. This will help alendronate reach your stomach faster. It will also help prevent irritation to your oesophagus. It is important to take calcium tablets after alendronate consumption. Please consult your physician he will examine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Penchila Prasad Kandikattu , Internal Medicine Specialist