Bondronat Tablet 50mg contains the active ingredient ibandronic acid that is a type of medicine called a bisphosphonate that works to reduce the turnover of bone in the body. As bone is not a static structure and can be continually reshaped, reformed and rebuilt it is vulnerable to excessive breakdown. This is particularly prominent when breast cancer has spread into the bones, which can lead to areas of bone weakness, pain and fractures. The ibandronic acid can therefore be used to bind to the bone and prevent it from being broken down.
This particular type of medicine works by binding tightly to the bone tissue and prevents calcium from being removed and escaping into the blood and preventing the bone from breaking down further. The breakdown of bone and the increase of calcium in the blood can cause symptoms such as nausea, tiredness and confusion. As the ibandronic acid prevents the calcium from being removed from the bone, it can also be used to treat high calcium levels in the blood as a result of cancer.
Directions for taking Bondronat Tablet 50mg:
- It is very important that the instructions for taking Bondronat tablets are followed completely. This is because when the ibandronic acid is taken by mouth it can cause irritation and ulceration of the foodpipe (oesophagus). Following the instructions below minimises this risk. If you are unclear about anything ask your pharmacist for advice.
- Bondronat tablets should be taken in the morning after an overnight fast (at least six hours) and before the first food, drink or medicine of the day.
- The tablet should be swallowed whole with a glass of plain water (180 to 240ml, not mineral water) while you are sitting or standing in an upright position. Do not crush, chew or suck the tablets.
- You should not lie down for one hour after taking your Bondronat tablet.
- You should not eat or drink anything other than plain water for at least 30 minutes after taking the tablet. This is because food and some drinks (including mineral water) can interfere with the absorption of the medicine from the gut and hence make it less effective.
- You should not take any other medicine by mouth in the six hours before you take your Bondronat tablet, at the same time as your Bondronat tablet, or in the hour after you have taken the tablet. See the end of this factsheet for more details.
Caution before taking Bondronat Tabelt 50mg:
- If you experience any signs of irritation to your foodpipe during treatment with this medicine, for example new or worsening problems with swallowing, pain on swallowing, pain behind your breastbone, or heartburn, you should stop taking Bondronat tablets and inform your doctor.
- Your doctor will want you to have regular blood tests to monitor your kidney function and the level of calcium, phosphate and magnesium in your blood while you are having treatment with this medicine.
- The class of medicines that ibandronic acid belongs to (bisphosphonates) has been associated with a rare condition called osteonecrosis of the jaw. The majority of cases of this condition have been in cancer patients treated with bisphosphonates by injection into a vein, and many of these people were also having treatment with chemotherapy or corticosteroids. However, the condition has also been seen in people taking bisphosphonates by mouth. The risk may also be increased by poor oral hygiene, dental problems such as gum disease or poorly fitting dentures, teeth extractions, oral surgery and smoking. For this reason, you should have a dental examination and, if necessary, appropriate preventive dentistry, before you start treatment with this medicine. Discuss this with your doctor. It is important to look after your mouth and teeth as much as possible while you are taking this medicine. You should have regular check-ups with your dentist and get advice straight away if you have any problems with your mouth or teeth. When you see a dentist during treatment, make sure they know you are taking this medicine. Invasive dental procedures such as tooth extraction or surgery should be avoided if possible.
- Some people being treated with bisphosphonates (mainly people having long-term treatment for osteoporosis) have experienced an unusual fracture of their thigh bone. For this reason it is important to let your doctor know if you get any pain in your thighs, hips or groin while you are having treatment with this medicine. These symptoms could be an early indication of a possible fracture.
Use with caution in:
- People who are allergic to other bisphosphonate medicines
- Decreased kidney function
- Disorders of the parathyroid gland (gland that produces hormones responsible for regulating calcium metabolism)
- Vitamin D deficiency
- Bondronat tablets should be used with caution in people with active disorders of the upper part of the digestive system, such as difficulty swallowing, disorders affecting the foodpipe (eg reflux disease), ulcers, inflammation of the lining of the stomach (gastritis), inflammation of the small intestine (duodenitis)
Not to be used in:
- People who have a low level of calcium in their blood (hypocalcaemia). If your dietary intake of calcium and vitamin D is low your doctor may ask you to take calcium and vitamin D supplements
- Bondronat tablets should not be used in people who have any abnormality of the foodpipe (oesophagus) that causes difficulty swallowing or delayed passage of food through the foodpipe, eg narrowing or achalasia of the foodpipe
- Bondronat tablets should not be used in people who cannot stand or sit upright for at least 60 minutes
- Bondronat tablets contain lactose and should not be taken people with rare hereditary problems of galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption
- Bondronat is not recommended for children under 18 years of age
Possible side effects from taking Bondronat Tablet 50mg:
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
If you notice any of these side effects worsen, or if they don't go away, please contact your doctor immediately.
- Low blood calcium level (hypocalcaemia)
- Flu-like symptoms
- Nausea and vomiting
- Abdominal pain
- Bone pain
- Pain in the muscles or joints
- Feeling of weakness
- Taste disturbance
- Inflammation of the foodpipe (oesophagitis - Bondronat tablets only)
- Difficulty swallowing
- Inflammation of the stomach (gastritis)
- Pins and needles sensations
- Eye inflammation
- Osteonecrosis of the jaw (see warning section above)
- Unusual fractures of the thigh bone (see warning section above)