Each time you collect a prescription, make sure you have been given the same brand of tablet as before. This is because there are different brands of ibandronic acid tablets and not all are used for the same condition.
If you buy any medicines, make sure your pharmacist knows that you are taking these tablets, as some medicines will prevent ibandronic acid from working properly.
Good dental hygiene is particularly important with this treatment - this means that you must brush your teeth regularly, and have routine dental check-ups.
About ibandronic acid
|Type of medicine||Bisphosphonate|
|Used for||Osteoporosis; to prevent bone damage in people with breast cancer that has spread to the bone; or to reduce high levels of calcium in the blood caused by cancer (injection only)|
|Also called||Bonviva®; Bondronat®; Iasibon®; Quodixor®|
|Available as||Tablets and injection|
You will be prescribed ibandronic acid to prevent bone damage (in conditions such as osteoporosis or if you have a secondary bone cancer), or to reduce a high blood level of calcium resulting from a cancer that has spread to your bone.
When ibandronic acid is used to treat osteoporosis (Bonviva® brand), it is only suitable for women who have been through the menopause. Osteoporosis is a bone disease which causes your bones to become brittle and fragile, making them prone to breaks and fractures. During our lifetime, old bone tissue is constantly being broken down and replaced by new bone. After the age of about 35 years, our bone begins to lose density because old bone is lost faster than new bone can replace it. Women in particular have an increased risk of developing osteoporosis because they lose bone material rapidly after the menopause. Ibandronic acid slows down the rate at which old bone is lost. New bone continues to be made and this leads to an overall increase in bone density, which reduces your risk of broken bones and fractures.
Ibandronic acid (Bondronat® brand) is used to help treat complications associated with cancer. In some cancers there can be an excessive breakdown of bone. As this happens, the bone is weakened and calcium is lost from the bone and seeps into the blood, leading to higher-than-normal blood levels of calcium. Ibandronic acid helps by binding to bone, making the bone stronger and reducing the amount of calcium leaving the bone.
Before taking ibandronic acid
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking these tablets it is important that your doctor or pharmacist knows:
- If you are pregnant or breast-feeding.
- If you have ever had any difficulties swallowing.
- If you are due to have any dental treatment in the near future, or if you have not recently had a dental check-up.
- If you have kidney or heart problems.
- If you are unable to sit upright for at least 60 minutes.
- If you have been told you have low amounts of calcium in your blood.
- If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How to take ibandronic acid
- Before you start this treatment, read the manufacturer's printed information leaflet from inside your pack. The leaflet will give you more information about the specific brand of tablets you have been given, and a full list of side-effects which you may experience from taking them. Not all brands of tablet are used to treat each of the conditions mentioned in this leaflet.
- If you are taking Bonviva® tablets: the usual dose is one 150 mg tablet, once a month. You must take your dose on the same day of each month, so choose a day that best suits your routine. If you forget to take a dose, take it on the morning after you remember. However, if when you remember, your next dose is due within seven days, then you should not take the missed tablet, just take your next dose when it is due.
- If you are taking Bondronat® tablets: the usual dose is one 50 mg tablet each morning, although you may be asked to take it less frequently than this if you have any problems with the way your kidneys work. If on any day you forget to take a dose, just take your tablet on the next day as usual. Do not take a double dose to make up for a missed dose
Taking ibandronic acid tablets:
It is important that you take each tablet of ibandronic acid in the correct way, as otherwise they can cause irritation and damage as they are swallowed.
- Take the tablet first thing in the morning, before you eat any food or have anything to drink other than water. You should also make sure it is more than six hours since you last ate food on the previous day.
- Swallow the tablet whole - you must not chew, break, or crush the tablet. You must drink a large glassful of water as you take the tablet, and it is important that you take the tablet while you are standing or sitting in an upright position.
- Continue to sit or stand upright for 60 minutes after taking a tablet - you must not lie down during this time.
- Do not have anything to eat or drink (other than water) for at least 30 minutes after taking a tablet. If you are taking Bonviva® tablets, you must not eat or drink anything (other than water) for 60 minutes afterwards. This is because food stops the tablet from working and makes your treatment much less effective.
Getting the most from your treatment
- Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress. It is likely you will need to have regular blood tests during this treatment.
- Good dental hygiene is particularly important while you are taking these tablets - brush your teeth regularly and remember to have routine dental check-ups. Tell your dentist that you are taking ibandronic acid, as some dental treatments may not be recommended for you while you are taking these tablets.
- If you buy any medicines, check with a pharmacist that they are suitable for you to take. This is because mineral supplements, iron preparations, and some indigestion remedies reduce the amount of ibandronic acid which your body absorbs. This may make your treatment less effective.
- Eating a well-balanced diet and taking regular exercise can help your bones stay strong. Remember to follow any exercise or dietary advice your doctor gives to you.
- Chemicals from tobacco can get into your bloodstream and can affect your bones, making bone loss worse. If you smoke, you should try to make every effort to stop. Ask your doctor or pharmacist for advice on stopping.
Can ibandronic acid cause problems?
Along with their useful effects, all medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.
|Common ibandronic acid side-effects - these affect less than 1 in 10 people who take this medicine||What can I do if I experience this?|
|Indigestion, feeling sick, stomach ache||Stick to simple foods - avoid rich or spicy meals|
|Muscle and joint pains, 'flu-like' feelings||These may occur at the beginning of treatment but should soon pass. If they continue beyond the first few days, let your doctor know|
|Headache||Ask your pharmacist to recommend a suitable painkiller|
|Less common, but possibly serious side-effects||What can I do if I experience this?|
|Heartburn, pain or difficulty when you swallow||Speak with your doctor as soon as possible - these may be signs that the tablets are irritating your throat|
|Pain in your thigh, hip, or groin||Speak with your doctor as soon as possible - these may be signs of a thigh bone fracture|
|A loose tooth, or jaw pain with swelling or numbness||Speak with your doctor as soon as possible - these may be signs of a problem called osteonecrosis of the jaw|
If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.
How to store ibandronic acid
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital at once. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading & references
- Manufacturer's PIL, Bondronat® 50 mg film-coated tablets; Roche Products Limited, The electronic Medicines Compendium. Dated November 2012.
- Manufacturer's PIL, Bonviva® 150 mg film-coated tablets; Roche Products Limited, The electronic Medicines Compendium. Dated November 2012.
- British National Formulary; 65th Edition (Mar 2013) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
Dr John Cox