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Hi, Thank you for your question. The directions for use are important because the body doesn't absorb the medication very well. If you take Actonel with food, your body can't absorb it as well, and therefore the medication doesn't work as well. Same thing goes for taking it with other medications. The 30 minute break gives your stomach time to break down the Actonel tablet and get it absorbed into your bloodstream. It's recommended that you sit upright or stand after taking it, because the Actonel can cause serious damage to your stomach lining and/or esophagus if you lie down. You should also take this medication with a full glass of water - this helps to dissolve the tablet so that it can be absorbed more quickly into your bloodstream. You can read more about Actonel here. If you are having trouble following all of these instructions, discuss with your doctor the possibility of switching to Boniva. Boniva is a similar medication, but you would only need to take it once a month instead of once a week. There are also similar medications made in IV form, but they may be more expensive.  I hope this helps. Best of luck, Casey