<<Disclaimer: Verify this information before applying it to your situation.>> An article in "The Moisture Seekers Newsletter" published by the Sjogren's Syndrome Foundation, Vol 14, No. 7, Oct 1996 cites an article in the New England Journal of Medicine (no reference given) concerning serious esophageal damage with fosomax. The damage occurs when the pills are not swallowed completely and are in prolonged contact with the esophagus. The author of the NEJM article recommends that patients take the medication first thing in the morning with 6-8 oz water and remain sitting or standing for at least 1/2 hour. Patients should not lie down until after eating breakfast. Fosomax is the drug used to rebuild bone with osteoporosis. Karen Hughes