As for the bisphosphonates in general may cause gastrointestinal disturbances including abdominal pain, nausea and vomiting, and diarrhoea or constipation. Peptic ulceration has been reported. Existing gastrointestinal problems may be exacerbated, and oral bisphosphonates should generally be given with care or avoided if acute upper gastrointestinal inflammation is present. Gastrointestinal symptoms such as abdominal pain, dyspepsia, diarrhoea or constipation are the most frequent adverse effects with alendronate. Severe oesophageal reactions such as oesophagitis, erosions, ulceration, and stricture have occurred; patients should be advised to stop taking the tablets and seek medical attention if they develop symptoms such as dysphagia, new or worsening heartburn, pain on swallowing, or retrosternal pain. Peptic ulceration has also been reported.
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