NHS Greater Glasgow & Clyde Area Drug and Therapeutics Committee
Greater Glasgow and Clyde Medicines
Medicines Update

Alendronic acid

New formulation

Binosto® 70mg effervescent tablets have been added to Total Formulary restricted to patients who are unable to swallow tablets where alendronic acid is the appropriate treatment choice.


  • The first line bisphosphonate for osteoporosis is generic alendronic acid tablets
  • The 70mg standard tablet preparation is the preferred formulation
  • The effervescent formulation is subject to the same administration requirements as the standard tablets
  • There is no evidence that the effervescent formulation improves GI tolerability


Effervescent tablets cost around £300 per patient per year (similar price to liquid formulations) compared to £14 for standard tablets. If swallowing difficulties exist, consider whether alternative non-oral options may be more suitable. This may require discussion with the specialist service.