Always ask! It is important to have a clear answer and that you pursue any response that is unclear. I think that insurance and habit drive the alendronate path. It is cheap compared to other meds . The troyble with having a bisphosphonate first is that they can sometimes blunt the positive effects of a bone uilder like tymlos, forteo and evenity. Proper sequencing of these drugs is very important. We cannot be passive. We must make demands on our physicians and the medical systems they working. It is absolutely imperitive that we do our own research and prepare in advance for these medical appointments.