Isotretinoin manufacturers note esophageal irritation may occur when the medication is not swallowed whole with a glass of water. This corresponds to areas of extrinsic compression by the mainstem bronchus, aorta, or cardiac atrium where pills or capsules are. To facilitate delivery to the stomach and thus reduce the potential for esophageal irritation, a fosamax tablet should be swallowed with a full glass of water.
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