You have been prescribed Binosto.

This treatment guide explains what Binosto is, why you have been prescribed it, and how to take it to treat your condition.

This website is designed to support you with your treatment and is not a substitute for the Patient Information Leaflet that came with your medication.

If you have any worries about your treatment, it is important to talk them through with a member of your healthcare team. Do not stop taking this medicine unless your Healthcare Professional tells you to do so.

Please also be sure to read the Patient Information Leaflet that comes in your Binosto pack for full details on how to take your treatment.

What is Binosto?

Binosto is an established treatment to treat women who have osteoporosis after the menopause to protect them from hip and spine fractures.1

What is osteoporosis?

Osteoporosis is a condition where bones become weak and fragile, making them break more easily.1

Bone is living tissue that is constantly being broken down and replaced. Osteoporosis occurs when the creation of new bone doesn’t keep up with the loss of your old bone.2,3

Imagine inside your bones is like a honeycomb. With osteoporosis, the holes in the honeycomb gradually become larger, making your bones become weaker over time.3

Most people don’t know they have osteoporosis until it causes them to break a bone. That’s why it is called a “silent disease”.3

Although fractures can occur in different parts of the body, the hip, wrist and spine are the most commonly affected sites.4

Why did I get osteoporosis?

Women are at a higher risk for osteoporosis after the menopause because they have lower levels of oestrogen, a hormone that helps your bones to stay strong.4 As many as 1 in 3 women over 50 will suffer a bone fracture due to osteoporosis, so it is fairly common.5

What are the consequences of osteoporosis?

With enough force, anyone can break a bone. When you have osteoporosis, however, just a simple fall can result in a broken bone.6 While the hip, wrist and spine are the most affected sites, fractures can occur in other parts of the body.4

Spine fractures from osteoporosis typically happen in the lower or middle back.7

Hip fractures are most common in people in their late 70s, but they can occur in younger people too.8

By taking Binosto in the way your doctor has instructed you to, you can increase your bone density and so reduce your risk of suffering a hip or spine fracture in the future.9,10

How does Binosto work?

As you age, your bone density tends to decrease because your body breaks down bone faster than it forms new bone. Binosto contains alendronate, which belongs to a group of medicines called bisphosphonates. They work by slowing down bone removal, so that bone-forming cells have time to rebuild new bone.9 This helps strengthen your bones and prevent future bone fractures.

How do I take Binosto?

Binosto is a once-weekly effervescent tablet that you dissolve in water before taking.10

When you get up in the morning on your chosen day, before you have anything to eat or drink, dissolve one tablet in 120 ml of plain water. If need be, give it a stir to make sure the tablet is completely dissolved.10

Drink all the Binosto mixture in one sitting, followed by at least 30 ml of plain water (you can drink more plain tap water if you’d like). Then wait at least 30 minutes before having your first food or drink of the day and before taking other medication since other things in your stomach can stop Binosto from working properly.9,10

For that half hour, it’s also important that you don’t lie down - you need to sit or stand upright (or walk around) for the 30 minutes after you take Binosto.10

This will help the medicine reach your stomach and reduce the risk of unpleasant side effects or interactions with food or other medicines.11

Why is Binosto dissolved in water?

Some people have problems swallowing tablets. If an alendronate tablet gets stuck on the way down, it can irritate or injure your oesophagus (the tube that connects your throat to stomach).11 Because Binosto is dissolved in water, you can avoid the problem of alendronate lodging in your oesophagus.11

Since you need to take Binosto on an empty stomach (see the next question), you should not mix Binosto into any other drinks apart from plain water.10

Why do I need to take Binosto on an empty stomach?

Alendronate is not an easy medicine for your body to absorb.9 If you have food or drink other than plain water before taking alendronate, it can bind to the medicine preventing it from getting to work for your bones.9 An empty stomach means that you absorb as much of the drug as possible.

What difference does Binosto being “buffered” make?

Bisphosphonates can be irritating to the oesophagus and stomach because they are quite acidic. However, Binosto has a substance called a buffer added to make it less acidic.11 The buffer doesn’t change the medicine’s main effects, it just makes it less likely to cause irritation when you take it.

Is Binosto okay for people with allergies/food sensitivities?

Binosto contains the following ingredients:

  • Sodium dihydrogen citrate
  • Citric acid anhydrous
  • Sodium hydrogen carbonate
  • Sodium carbonate anhydrous
  • Strawberry flavour [Maltodextrin (Maize), Arabic gum, Propylene glycol (E 1520), nature-identical flavouring substances]
  • Acesulfame potassium
  • Sucralose

Binosto does not contain lactose, wheat, or ingredients made from rapeseed oil.

The strawberry flavour comes from corn; the citric acid and monosodium citrate it contains are made from sugar beet and cane sugar

Can I take Binosto if I am vegetarian/vegan?

Binosto is suitable for vegetarians and vegans as it does not contain any animal-derived ingredients.

What should I do if I forget to take Binosto?

If you miss a dose, don’t worry. Just take Binosto as you normally would on the morning after you remember. You can then return to taking Binosto on your original chosen day. Do not take two tablets together.10

What should I do if I take more Binosto than I should?

If you take too many Binosto tablets by mistake, drink a full glass of milk and contact your doctor as soon as possible. Do not make yourself sick, and do not lie down.10

How do I know if Binosto is working?

As osteoporosis is a “silent” condition that you can’t feel, you won’t be able to sense Binosto working inside you. But it’s essential to take the medicine exactly as your doctor recommends. There is a lot of evidence to show that if you do not take treatments like Binosto as instructed, your risk of suffering a fracture will significantly increase.12 Over time, bone scans will show you the difference Binosto is making to the strength of your bones.

Will I have any side effects with Binosto?

Side effects are always a possibility with any kind of medication. So while not everyone does suffer side effects, there’s a chance you may do. You will reduce the chance of these effects if you take your medicine exactly as instructed.

The main side effects of Binosto affect the digestive system, so you might experience stomach pain, wind or indigestion, acid reflux, or nausea. If you do notice any of these side effects, get in touch with your doctor or pharmacist for their advice.10

Be sure to read the Patient Information Leaflet that comes with your medication for further details on possible side effects.

If you experience any side effects, talk to your Healthcare Professional. This includes any possible side effects not listed in the package leaflet. You can also report side effects directly via the Yellow Card Scheme at

You should continue taking Binosto until your Healthcare Professional advises you to stop.

Where can I find out more about osteoporosis?

If you would like more information about osteoporosis, or want to talk to someone about your condition, the Royal Osteoporosis Society has a helpline staffed by specialist nurses. You can give them a call on 0808 800 0035 or send an email enquiry to

Patient Guide Download

We are proud to be a partner of the Royal Osteoporosis Society.

Take 5 minutes to check your bone health risk using the Royal Osteoporosis Society’s risk checker

  1. Dimai HP, Fahrleitner-Pammer A. Best Pract Res Clin Rheumatol 2022; 36(3): 101780.
  2. Porter JL, Varacallo M. Available at: Accessed on: 06.11.23.
  3. National Institute on Aging. Available at: Accessed on: 06.11.23.
  4. Gopinath V. Med Clin North Am 2023; 107(2): 213-25.
  5. Sözen T et al. Eur J Rheumatol 2017; 4(1): 46-56.
  6. Royal Osteoporosis Society. Available at: Accessed on: 06.11.23.
  1. Donnally III CJ et al. Available at: Accessed on: 06.11.23.
  2. Johnell O, Kanis JA. Osteoporos Int 2006; 17(12): 1726-33.
  3. Kanis JA et al. Osteoporos Int 2019; 30(1): 3-44.
  4. Binosto Summary of Product Characteristics
  5. Hodges LA et al. Int J Pharm 2012; 432(1-2): 57-62.
  6. Vytrisalova M et al. Climacteric 2015; 18(4): 608-16.

Reporting of side effects. If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in the package leaflet. You can also report side effects directly via the Yellow Card Scheme at By reporting side effects, you can help provide more information on the safety of this medicine.

UK-BINO-37(1)     |     Date of Preparation February 2024