What’s the difference between alternate and alternative?

When you want to say one after the other, it’s alternate:

The two nurses work on alternate days.
She’s on call on alternate weekends.
Effective treatment involves the alternate use of red and blue puffers.

When you want to say one instead of the other, it’s alternative:

Complementary and alternative medicine (CAM) has become popular.
Would you like to try an alternative treatment?
The only alternative to taking medication long term is surgery.

To help remember the difference, the v in alternative stands for one thing versus another.

And see here, here and here for more explanations about common confusions.

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© Christina Wielgolawski