An 84-year-old woman presented to the author's hospital with a 5-day history of progressive odynophagia, epigastralgia and nausea. These symptoms developed 3 days after taking an alendronate oral tablet (35 mg once-weekly) for the treatment of postmenopausal osteoporosis. The patient's other medication consisted of 10 mg/day of rivaroxaban for atrial fibrillation; 200 mg/day of cilostazol for lacunar infarction; 20 mg/day of esomeprazole and 300 mg/day of rebamipide for the prevention of peptic ulcer.