Ibandronic acid

Ibandronic acid belongs to a group of drugs called bisphosphonates. It can be used to treat bone weakness or pain caused by breast cancer that has spread to the bone (secondary bone cancer). Ibandronic acid can also be used to treat high levels of calcium in the blood.

Secondary bone cancer may cause the bones to lose calcium, making them weak and painful. The calcium goes into the blood. If blood levels of calcium are too high it can cause sickness, tiredness, irritability and confusion.

Ibandronic acid reduces the amount of calcium lost from the bones. This can help strengthen the bones and reduce pain. It can also help to bring blood levels of calcium back to normal.

Ibandronic acid can be given as a drip (infusion) or as a tablet. Ibandronic acid can cause side effects. If these happen they are usually mild but occasionally can be severe. It is important to read the detailed information below so that you are aware of possible side effects. Tell your doctor or nurse if you notice any changes.

Ibandronic acid (Bondronat®)

Ibandronic acid belongs to a group of drugs called bisphosphonates. It can be used to treat:

  • a raised calcium level in the blood caused by cancer that has spread to the bones
  • bone weakness or pain caused by breast cancer that has spread to the bones.

Cancer that has spread to the bones is called secondary bone cancer. It happens when cells from the original (primary) cancer spread to form a new tumour (secondary cancer or metastasis) in the bone.

Ibandronic acid can be given alongside other cancer treatments.


The effect of cancer on the bones

In normal bone, two types of cell called osteoclasts and osteoblasts work together to keep your bones healthy:

  • Osteoclasts destroy old bone.
  • Osteoblasts build new bone.

Myeloma and some secondary bone cancers make chemicals that cause osteoclasts to work harder. This means that more bone is destroyed than rebuilt. The affected bone becomes weak and painful and can break more easily.

Bones contain calcium, which gives them strength. A bone affected by secondary cancer or myeloma may lose calcium into the blood. A raised level of calcium in the blood is called hypercalcaemia. This may cause you to have symptoms including feeling sick (nausea), vomiting, tiredness, irritability and sometimes confusion.


How ibandronic acid works

Ibandronic acid reduces the activity of osteoclasts. This can help to reduce pain and strengthen the bone.

Ibandronic acid also reduces the amount of calcium lost from the bones. This helps calcium levels in the blood return to normal.


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.

Ibandronic acid given to lower a high calcium level is usually given in a single dose.

Taking ibandronic acid tablets

Always take ibandronic acid tablets exactly as explained. This is important to make sure they work as well as possible for you. Ibandronic acid can attach itself to certain substances in food, drinks and medicines. If this happens it may not be absorbed properly and it may not work as well.

Check with your doctor or pharmacist if you are not sure.

It is best to take the tablet first thing in the morning. Take it on an empty stomach - do not eat or drink anything, or take any other medicines, for at least six hours beforehand. Swallow the tablet whole, with a full glass of plain tap water (not bottled mineral water).

You need to sit up straight or stand up when you swallow it. This is to make sure the tablet is washed down well. This prevents it from irritating your gullet (the tube from your mouth to your stomach).

Stay sitting or standing for an hour after you have taken the tablet. If you are in bed, prop yourself up with pillows. After you have swallowed the tablet, don’t eat, drink (other than tap water) or take any other medicines by mouth for at least an hour.


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 have more. The side effects described below won't affect everyone having ibandronic acid. If you are taking other drugs, you may have some side effects that we don’t list here.

We explain the most common side effects here 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 have had stomach problems before, ibandronic acid can make them worse. Your doctor will monitor you closely if you have 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.

Numbness or tingling around the mouth or in the fingers and toes

You may notice this if the calcium level in your blood drops below normal. Your doctor will do regular blood tests to monitor your calcium levels. Contact a doctor straight away if you have any of these symptoms.

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.

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.

Headaches

Some people have headaches when taking 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.

Effect on the kidneys

Ibandronic acid can affect how your kidneys work. Drinking plenty of fluids will help your kidneys work well. Your doctor will check how well your kidneys are working with regular blood tests.

Jaw problems

Rarely ibandronic acid can cause tissue in the jaw bone to die. This is called osteonecrosis of the jaw. The risk of this happening is higher in people who have gum disease, problems with dentures, or after a dental treatment such as having a tooth removed.

To reduce your risk your doctor will advise you to:

  • have a full dental check-up before starting treatment
  • look after your teeth and gums during treatment (ask your dentist for advice)
  • tell your dentist you are taking ibandronic acid before having any dental treatment.

You should always tell your cancer specialist and dentist straight away if you have pain, swelling or redness in your gums, numbness or heaviness in your jaw or loose teeth.


Additional information

Admission to hospital

If you are admitted to hospital for a reason not related to the cancer, it is important to tell the doctors and nurses looking after you that you are 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.

Pregnancy and breastfeeding

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.

Back to Bisphosphonates

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Zoledronic acid

Zoledronic acid can strengthen bones and relieve pain in some secondary bone cancers, and can lower calcium levels in the blood.