However, to make sure that alendronate is absorbed, it must be swallowed with a full glass of water the first thing on arising for the day, and no other food or drink should be taken for the next 30 minutes. Because alendronate can irritate the lining of the upper gastrointestinal tract, the person must not lie down after taking a dose for at least the next 30 minutes, until they have had something to eat. Certain people with difficulty swallowing or with certain disorders of the esophagus or stomach should not use it. Many authorities recommend calcitonin, particularly for people who have painful fractures of the vertebrae. This drug can be taken by injection or nasal spray.
Fluoride supplements can increase bone density.
However, because the resulting bone may be abnormal and fragile, they are not generally recommended. New forms of fluoride, which may not have adverse effects on bone quality, are being tested. Men who have osteoporosis usually take calcium and vitamin D supplements, especially if tests show that their body isn't absorbing adequate amounts of calcium. Men don't benefit from estrogen, but may benefit from testosterone if their testosterone level is low. Fractures resulting from osteoporosis must be treated.