Food and medicine interaction

Coffee, tea, juice, milk and mineral water and alendronate (Fosamax) and other oral bisphosphonates for osteoporosis

EstablishedEvidence level: established. Shown in drug labeling or in controlled studies in people.

Last reviewed October 19, 2026

What can happen

Very little alendronate is absorbed even under ideal conditions, and drinks other than plain water cut that further. In controlled studies, black coffee or orange juice taken with the tablet reduced absorption by about 60 percent, and taking it with or soon after breakfast reduced it by more than 85 percent.

Why it happens: Alendronate is very poorly absorbed (under 1 percent of a dose with plain water in the studies), and food or any drink other than water in the stomach cuts that further.
At ordinary food amounts: Ordinary amounts matter: a single cup of coffee or glass of juice with the tablet was enough to lower absorption in the study. After the 30-minute wait, your usual breakfast is fine.

What to do

Never stop or change a prescribed medicine without talking to the prescriber.

Common questions

Can I have coffee, tea, juice, milk and mineral water while taking bisphosphonates?

MedlinePlus says to take alendronate with plain water only and wait at least 30 minutes before eating, drinking anything else or taking other medicines. If that routine is hard to keep, ask your prescriber or pharmacist about options rather than skipping doses. Ordinary amounts matter: a single cup of coffee or glass of juice with the tablet was enough to lower absorption in the study. After the 30-minute wait, your usual breakfast is fine.