Ibandronic acid

Ibandronic acid is a type of drug called a bisphosphonate. Bisphosphonates are used to treat osteoporosis.  This is a condition when the bones become thinner or weaker. Some illnesses, like secondary bone cancer, can cause weakness in the bones.

Normally, two kinds of bone cell work together to keep bones healthy:

  • osteoclasts destroy old bone
  • osteoblasts build new bone.

Some cancers can cause osteoclasts to work too hard, destroying more bone cells than are created. This can weaken the bone, cause pain, or increase the amount of calcium in the blood. Ibandronic acid can slow the action of osteoclasts, allowing the bone to recover and lower the raised calcium level in the blood.

Ibandronic acid is given as a drip or as a tablet. There are some side effects associated with ibandronic acid. Not everyone having the treatment will have all the side effects. Any changes should be discussed with your doctor or nurse.

Ibandronic acid (Bondronat®)

Ibandronic acid belongs to a group of drugs called bisphosphonates. Bisphosphonates are commonly used to treat bone thinning (osteoporosis). In certain situations they can help protect your bones against some of the effects of secondary bone cancer, such as pain and weakness. Secondary bone cancer occurs when the original (primary) cancer spreads to form a new tumour (secondary cancer or metastasis) in the bone.

Ibandronic acid can be given alongside other cancer treatments. It may be given to women with breast cancer that has spread to the bones. It can be used to prevent and treat problems caused by secondary bone cancer and to reduce a raised calcium level in the blood.

The effect of cancer on the bones

When bones are affected by secondary cancer, increased amounts of calcium (the substance that helps to build bones) may be released into the blood. A raised level of calcium in the blood is known as hypercalcaemia. This can cause symptoms such as feeling sick (nausea) or being sick (vomiting), tiredness, irritability and sometimes confusion. Ibandronic acid helps reduce high levels of calcium.

Secondary cancer in the bones may make them weak, and in some situations they may break (fracture). Ibandronic acid helps strengthen the bone and reduce the risk of fractures. It also helps reduce pain in the bones.

Cancer can affect the bones in different ways, and ibandronic acid is only helpful for some cancers that affect the bones. Your doctor or specialist nurse can tell you if it would be helpful for you.

How ibandronic acid works

In normal bones, two types of cells called osteoclasts and osteoblasts work together constantly to shape, rebuild and strengthen existing bone:

  • osteoclasts destroy old bone
  • osteoblasts build new bone.

Some secondary bone cancers produce chemicals that make the osteoclasts work harder. This means that more bone is destroyed than rebuilt, which leads to weakening of the affected bone. This can cause pain and means that the bone can fracture or break more easily.

Ibandronic acid targets areas of bone where there is cancer and the osteoclast activity is high. It helps bring the balance of osteoclast and osteoblast activity back to normal by reducing the activity of the osteoclasts. This can reduce pain and help strengthen the bone. It also means that less calcium will be lost from the bones.

How ibandronic is given

You may be given ibandronic acid by drip (infusion) or as a tablet.

If you are given it as an infusion, it will usually be done in the outpatient department at the hospital. Ibandronic acid is given by a drip into the vein through a fine tube called a cannula. The infusion can take up to an hour and is usually given every 3-4 weeks. You may be given a single 'one-off' dose of ibandronic acid as a drip to lower a high calcium level.

Taking ibandronic tablets

It’s important to carefully follow the advice on how to take your tablets. Your doctor, nurse or pharmacist will explain this to you.

It’s best to take the tablet first thing in the morning. Make sure that you take it on an empty stomach - do not eat or drink anything, or take any other medicines, for at least six hours beforehand. This is because ibandronic acid can attach itself to certain substances in food, drinks and medicines. If this happens it may not be absorbed properly and its effectiveness may be reduced as a result.

Swallow the tablet whole, with a full glass of plain tap water (not bottled mineral water). You’ll need to sit straight or stand up when you swallow it. This is to make sure the tablet is washed down well, which prevents it from irritating your gullet (the tube from your mouth to your stomach).

Stay sitting or standing for an hour after you’ve taken the tablet. If you’re in bed, prop yourself up with pillows. Don’t drink (except plain tap water), eat or take any other medicines for at least an hour after you’ve swallowed the tablet.

How long ibandronic acid is given for

Ibandronic acid usually needs to be taken for at least six months before it has its maximum effect. After that it can usually be taken for as long as it is working well for you.

Possible side effects

Some people have very few side effects while others may experience more. The side effects described below won't affect everyone who is having ibandronic acid and may be different if you are having more than one drug. We have outlined the most common side effects but haven't included those that are rare and therefore unlikely to affect you. If you notice any effects that aren't listed below, discuss them with your doctor or nurse.

Problems with swallowing or heartburn

This may be a sign that the drug is irritating your gullet. If you find swallowing painful or difficult, or if you have heartburn that is new or getting worse, stop taking ibandronic acid tablets. Let your doctor know as soon as you can.

Flu-like symptoms

These include a high temperature, chills and pains in your muscles or joints. Let your doctor know if these effects are troublesome. It may be helpful to take mild painkillers.

Indigestion and heartburn

Let your doctor know if this is a problem and if it continues or gets worse. They can prescribe medicine to help.

If you’ve had stomach problems before, ibandronic acid can make them worse. Your doctor will monitor you closely if you’ve had problems with your stomach in the past.

Feeling sick (nausea) or being sick (vomiting)

This is usually mild and can be controlled with anti-sickness (anti-emetic) tablets.

Abdominal (tummy) pain

If you experience this, let your doctor know if it is severe or if it continues.

Tingling sensation in lips or tongue

This happens because of a drop in calcium levels below normal and is usually only temporary. Your doctor will carry out regular blood tests to monitor the level of calcium in your blood.

Diarrhoea or constipation

Let your doctor know if you have diarrhoea or constipation. They can prescribe medicine to help with this. Remember to drink plenty of fluids.


Some people have headaches with ibandronic acid. Let your doctor know if you are getting headaches.

Less common side effects of ibandronic acid

Increased pain

Sometimes pain in the affected bone can become worse for a short time when you start taking ibandronic acid. If this happens, your doctor can prescribe painkillers for you until it wears off.

Itchy skin

Ibandronic acid may make your skin feel itchy.

Feeling tired

You may feel more tired than usual. Tell your doctor if this is a problem.

Taste changes

You may notice that food tastes different and that you have a dry mouth.

Changes in your blood

Ibandronic acid may cause changes in the blood such as anaemia (a low level of red blood cells). Your doctor can do blood tests to check this.

Change in kidney function

Ibandronic acid can sometimes affect how your kidneys work. This doesn't usually cause any symptoms, and the effects are generally mild. Your doctor will check how well your kidneys are working during your treatment by doing regular blood tests.

Jaw problems (osteonecrosis)

A rare side effect of ibandronic acid is a condition called osteonecrosis of the jaw. This is when healthy bone tissue in the jaw becomes damaged and dies. Gum disease, problems with your dentures and some dental treatments (such as having a tooth removed) can increase the risk of this. So before you start taking the drug you'll be advised to have a full dental check-up.

During treatment with bisphosphonates it's very important to look after your teeth by brushing them regularly and having routine dental check-ups. Always let your dentist know that you're taking bisphosphonates. Some of the symptoms of osteonecrosis can include pain, swelling, redness of the gums, loose teeth or a feeling of numbness or heaviness in your jaw. Tell your cancer specialist and dentist straight away if you have any of these symptoms.

Additional information


Ibandronic acid may harm an unborn baby. You should avoid becoming pregnant or breastfeeding while taking this drug. If you’re thinking of getting pregnant it’s best to talk to your specialist first.


You may be asked to take calcium and vitamin D supplements while having treatment with ibandronic acid. Your doctor will let you know if this is necessary.

Non-cancer admission

If you’re admitted to hospital for a reason not related to the cancer, it’s important to tell the doctors and nurses looking after you that you’re having treatment with bisphosphonates. You should tell them the name of your cancer specialist so that they can ask for advice.

Emergency contacts

It’s a good idea to know who you should contact if you have any problems or troublesome side effects when you’re at home.

Back to Bisphosphonates

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