Take ibandronic acid tablets first thing after you get up in the morning. Swallow the tablet whole with a large glass of plain water, at least half an hour before you have breakfast (or one hour before breakfast if you are taking Bonviva® tablets). Remain sitting or standing upright for at least 60 minutes after taking the tablet.
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 or supplements 'over the counter', make sure your pharmacist knows that you are taking a bisphosphonate medicine, 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||A bisphosphonate|
|Used for||Reducing bone damage in people with breast cancer that has spread to the bone; to reduce high levels of calcium in the blood caused by cancer (injection only); as a treatment for osteoporosis|
|Also called||50 mg tablets (for bone problems in breast cancer): Bondronat®; Iasibon®|
150 mg tablets (for osteoporosis): Bonviva®; Quodixor®
Injection for infusion: Bondronat®
|Available as||Tablets and injection|
The bisphosphonate medicine called ibandronic acid is prescribed for the treatment of three different conditions, all of which affect the bones. It is used as a treatment to reduce bone damage in people with breast cancer that has spread to the bone, and it is also used in people with cancer who have a high amount of calcium in their blood. It is also sometimes prescribed as a treatment to prevent further bone damage in women who have 'thinning' of the bones, a condition called osteoporosis.
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.
When ibandronic acid is used to treat osteoporosis, it is only suitable for women who have been through the menopause. Osteoporosis is a bone disease which causes bones to become brittle and fragile, making them prone to breaks and fractures. As we become older, 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 the risk of broken bones and fractures.
Ibandronic acid is often prescribed in tablet form, but it is also sometimes prescribed as an injection administered over a short period of time (usually ranging from 15 minutes to 2 hours). If you are prescribed it as an injection, it will be given to you by a doctor or nurse in a hospital clinic.
Before taking ibandronic acid
Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you have ibandronic acid it is important that your doctor knows:
- If you are pregnant or breast-feeding.
- If you have any difficulties swallowing, or if you have a digestion problem.
- 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 any problems with the way your kidneys work, or if you have a heart condition.
- 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, as well as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How to take ibandronic acid
- Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about ibandronic acid, and it will also provide you with a full list of the side-effects which you could experience from taking it. Not all brands of tablet are used to treat each of the conditions mentioned in this leaflet.
- If you are taking 50 mg tablets (for bone problems in breast cancer): 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 tablet, do not take the tablet at another time - just take the tablet due on the following day as usual. Do not take two tablets on the same day to make up for a missed dose.
- If you are taking 150 mg tablets (for osteoporosis): 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 on your usual day, take it on the morning after you remember. (If when you remember, your next dose is due within the next seven days then you should not take the missed tablet, just take your next dose when it is due.)
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 up 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
- Remember to keep your regular appointments with your doctor so that your progress can be monitored. You will need to have regular blood tests during this treatment.
- Good dental hygiene is important during treatment with this medicine - this means that you must brush your teeth regularly and attend routine dental check-ups. If you wear dentures, make sure these fit you properly. You should also make sure that your dentist is aware that you are having ibandronic acid, as some dental treatments may not be recommended for you while you are receiving this treatment.
- If you buy any medicines, check with a pharmacist that they are suitable for you to take. This is because some mineral supplements, iron preparations, and indigestion remedies reduce the amount of ibandronic acid which your body absorbs. This could 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 make every effort to stop. Ask your doctor or pharmacist for advice on stopping.
Can ibandronic acid cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the more common ones associated with ibandronic acid. The best place to find a full list of the side-effects which can be associated with your medicine, is from the manufacturer's printed information leaflet supplied with the medicine. Alternatively, you can find an example of a manufacturer's information leaflet in the reference section below. Speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Common ibandronic acid side-effects (these affect less than 1 in 10 people)||What can I do if I experience this?|
|Indigestion, feeling sick, tummy (abdominal) pain, diarrhoea||Stick to simple foods - avoid fatty or spicy meals|
|Heartburn, chest pain, pain or difficulty when you swallow||These are signs that the tablets are irritating your throat. Speak with your doctor straightaway (and do not take any more tablets in the meantime)|
|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||Drink plenty of water and ask your pharmacist to recommend a suitable painkiller. If the headache continues, speak with your doctor|
|Skin rash, feeling weak||If troublesome, speak with your doctor|
|Rare, but more serious side-effects||What should I do if I experience this?|
|Pain in your thigh, hip, or groin||These could be signs of a thigh bone fracture. Speak with your doctor straightaway|
|A loose tooth, jaw pain with swelling or numbness, a sore in the mouth that doesn't heal||These could be signs of a problem called osteonecrosis of the jaw. Speak with your doctor straightaway|
|Ear pain, discharge from an ear, ear infection||These could be signs of a problem called osteonecrosis of the ear. Speak with your doctor straightaway|
If you experience any other symptoms which you think may be due to the medicine, speak with your doctor or pharmacist for further advice.
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 April 2016.
- Manufacturer's PIL, Bonviva® 150 mg film-coated tablets; Roche Products Limited, The electronic Medicines Compendium. Dated April 2016.
- British National Formulary; 72nd Edition (Sep 2016) 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 makes no warranty as to its accuracy. Consult a doctor or other healthcare professional for diagnosis and treatment of medical conditions. For details see our conditions.
Dr John Cox