What is ibandronic acid?

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

More information about this treatment

This information is correct at time of publishing. But sometimes the types of cancer this treatment is used for, or treatment side effects, may change between revision dates.

You can talk to your cancer team if you want more detailed information about this treatment. Or visit the electronic Medicines Compendium (eMC) website, which has patient information leaflets (PIL) for individual drugs.

The effect of cancer on the bones

Bones are living and constantly renew themselves. This helps bones keep their strength and shape.

Inside the bones, there are 2 types of bone cell:

  • osteoclasts, which break down and remove old bone
  • osteoblasts, which build new bone.

When we are children and young adults our bones keep getting thicker and stronger. But, as we get older, osteoclasts begin to remove more bone than osteoblasts make. This means our bones slowly become thinner (less dense). In some people, too much bone is lost and they have an in-creased risk of bone fractures.

Myeloma and some secondary bone cancers make chemicals that cause osteoclasts to destroy more bone. 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 mye-loma may lose calcium from the bones 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
  • confusion.

How ibandronic acid works

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

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

How ibandronic acid is given

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

Having ibandronic acid by drip (intravenous infusion)

If you are given it as an infusion, it is usually done in the outpatient department at the hospital. The infusion can take up to 1 hour. It is usually given every 3 to 4 weeks.

If you are having ibandronic acid to lower a high calcium level, you usually only have one dose of treatment.

Taking ibandronic acid tablets

If you are having ibandronic acid as tablets, your cancer doctor, nurse or pharmacist will give you the tablets to take at home. Always take ibandronic acid tablets exactly the way you are told to. This is 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 may not work as well.

Ask your cancer doctor, nurse or pharmacist if you are not sure how to take the tablets.

  • Take the tablet first thing in the morning. 
  • Take it when you have an empty stomach. This means you should not eat or drink anything, or take any other medicines, for at least 6 hours before you have the tablet.  
  • Do not suck, chew or crush the tablet.
  • Swallow it whole, with a full glass of plain tap water.  If you cannot swallow or have difficulty swallowing, you must tell your doctor or pharmacist. 
  • You need to sit up straight or stand up when you swallow the tablets. This is to make sure the tablet is washed down well. This stops it from irritating your gullet (the tube that goes from your mouth to your stomach).
  • Stay sitting up straight or standing for 1 hour after you take the tablet. If you are in bed, sit upright supported with pillows. 
  • After you take the tablet, do not eat, drink anything (other than tap water), or take any other medicines by mouth for at least 30 minutes to 1 hour. The exact length of time you need to wait will depend on your dose of ibandronic acid. Your doctor or pharmacist will give you more information about this. 
  • If you miss a dose, contact your cancer doctor, nurse or pharmacist for advice on when you should take it.

Ibandronic acid can be given with other cancer treatments.

How long ibandronic acid is given for

You usually need to take ibandronic acid for at least 6 months before it has the maximum effect on your bones. After that, you can usually take it for as long as it is working well.

Dental check-up before you have ibandronic acid

Rarely, this treatment can affect the jawbone. You can read more about this in the “Less common side effects” section below.

Having a healthy mouth and teeth reduces your risk of jaw problems. You usually need a dental check-up to check for any problems before you start treatment.

If you need urgent treatment to lower high calcium levels in your blood, you do not usually need a dental check-up first.

About side effects

We explain the most common side effects of this treatment here. We also include some that are less common. 

You may get some of the side effects we mention, but you are unlikely to get all of them. And you may have some side effects, including rarer ones, that we have not listed here. 

Other cancer treatments may cause different side effects. If you are also having other cancer treatment, you may have other side effects.

Always tell your doctor, nurse or pharmacist about any side effects you have. They can give you: 

  • drugs to help control some side effects 
  • advice about managing side effects. 

It is important to take any drugs exactly as explained. This means they will be more likely to work for you.

Serious and life-threatening side effects

Some cancer treatments can cause serious side effects. Sometimes, these may be life-threatening. Your doctor, nurse or pharmacist can explain the risk of these side effects to you.

Contact the hospital

Your doctor, nurse or pharmacist will give you 24-hour contact numbers for the hospital. If you feel unwell or need advice, you can call at any time of the day or night. Save these numbers in your phone or keep them somewhere safe.

Common side effects

Flu-like symptoms

Some people have flu-like symptoms, such as:

  • a high temperature
  • chills
  • pains in your muscles or joints.

Tell your doctor if these effects do not get better within 2 days or are causing problems. It may be helpful to take mild painkillers such as paracetamol. Your doctor, nurse or pharmacist can give you advice.

Sore throat, or indigestion

This may be a sign that the drug is irritating your throat or gullet (the tube that goes from the mouth to the stomach). If swallowing is painful or difficult, or if you have indigestion that is new or getting worse, tell your doctor before taking any more ibandronic acid.

Feeling sick

You may feel sick or be sick (vomit) during treatment. This is usually mild. Your doctor can prescribe anti-sickness tablets to help.

Take the drugs exactly as your nurse or pharmacist tells you to. It is easier to prevent sickness than treat it after it has started.

Abdominal (tummy) pain

Tell your doctor if you have abdominal (tummy) pain that is severe, or continues.


This treatment may cause diarrhoea. Diarrhoea means passing more stools (poo) than is normal for you, or having watery or loose stools. You may also have stomach cramps. If you have a stoma, it may be more active than usual. 

If you are passing loose stools 3 or more times a day and this is not normal for you, contact the hospital as soon as possible on the 24-hour number. Follow the advice they give you about:

  • taking anti-diarrhoea medicines 
  • drinking enough fluids to keep you hydrated and to replace lost salts and minerals
  • any changes to your diet that might help. 

They might also ask you for a specimen of your stool to check for infection.

Headaches and dizziness

You may have headaches or feel dizzy at times when taking this treatment. Tell your doctor if you notice these symptoms.

Feeling tired (fatigue)

Feeling tired is a common side effect. Try to pace yourself and plan your day so you have time to rest between activities.

Being physically active can help to manage tiredness and give you more energy. It also:

  • helps you sleep better
  • reduces stress
  • improves your bone health.

If you feel sleepy, do not drive or operate machinery.

Increased bone pain

Sometimes pain in the affected bone gets worse for a short time when you start taking this treatment. If this happens, your doctor can prescribe painkillers to help.

Numbness or tingling

You may notice numbness or tingling around the mouth, or in the fingers and toes. This may be caused by low levels of calcium in your blood. You will have regular blood tests to check your calcium levels. Contact your doctor straight away if you have these symptoms.

Your doctor may ask you to take calcium and vitamin D supplements, unless you are having this treatment to lower the levels of calcium in your blood. Your doctor will let you know if you need any supplements.

Changes to your taste

You may get a bitter or strange taste in your mouth. Sucking sugar-free sweets may help with this. Some foods may taste different or have no taste. Try different foods to find out what tastes best to you. Your doctor or nurse can give you more advice.

Skin rash

This treatment can cause a rash. Tell your doctor if this happens. They can give you advice and may give you creams and medicines to help.

Effects on the eyes

This treatment can cause eye problems. If you have any of these symptoms during treatment or after it finishes, contact your doctor straight away:

  • double vision
  • redness or inflammation
  • eye pain
  • eyes that are sensitive to light
  • changes to your eyesight - things appear blurry or faded.

You may need to have an eye check with a specialist eye doctor (ophthalmologist).

Less common side effects

Allergic reaction

Some people have an allergic reaction while having this treatment. Signs of a reaction can include: 

  • feeling hot or flushed 
  • shivering
  • itching
  • a skin rash
  • feeling dizzy or sick
  • a headache
  • feeling breathless or wheezy
  • swelling of your face or mouth
  • pain in your back, tummy or chest. 

Your nurse will check you for signs of a reaction during your treatment. If you feel unwell or have any of these signs, tell them straight away. If you do have a reaction, they can treat it quickly. 

Sometimes a reaction happens a few hours after treatment. If you develop any of these signs or feel unwell after you get home, contact the hospital straight away on the 24-hour number.

Anaemia (low number of red blood cells)

This treatment can reduce the number of red blood cells in your blood. Red blood cells carry oxygen around the body. If the number of red blood cells is low, this is called anaemia. You may feel:

  • very low in energy
  • breathless 
  • dizzy and light-headed. 

If you have these symptoms, contact the hospital straight away on the 24-hour number. You may need treatment for anaemia. If you are very anaemic, you may need a drip to give you extra red blood cells. This is called a blood transfusion.

Effect on the kidneys

This treatment can affect how your kidneys work. Drinking plenty of fluids will help your kidneys work well. You will have blood tests to check how well your kidneys are working. Tell your doctor if:

  • you feel generally unwell
  • have any swelling of your face, arms, legs or tummy
  • you notice a change in how often you pass urine (pee).

Pain in the thigh, hip or groin

Sometimes pain in muscles or bones gets worse for a short time when you start taking zoledronic acid. If this happens, your doctor can prescribe painkillers for you until it gets better.

Rarely, people on this treatment develop a break (fracture) in their thigh bone without any obvious cause. Sometimes both thigh bones are affected.

If you have any thigh, hip or groin pain, tell your doctor. Mention that you are taking bisphosphonates. They can arrange tests to check the thigh bones for any signs of weakness or fracture.

Jaw problems

Rarely, this treatment can affect the jawbone. Healthy bone in the jaw becomes damaged and dies. This is called osteonecrosis of the jaw (ONJ). It can cause:

  • pain
  • loosening of the teeth
  • problems with the way the gums heal.

The risk of jaw problems is higher after some types of dental treatment and in people who have gum disease or dentures that do not fit well.

It is important to avoid having any dental treatment that could affect your jawbone when you are having bisphosphonates. This includes having a tooth or root removed or dental implants put in. You can still have fillings, gum treatments or a scale and polish.

To reduce your risk of developing jaw problems 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 a bisphosphonate before having any dental treatment.

Tell your cancer specialist and dentist straight away if you at any time you develop:

  • pain
  • swelling or redness in your gums
  • numbness or heaviness in your jaw
  • loose teeth.

Ear problems

Very rarely, bones in the outer ear may be affected by this treatment. Always tell your doctor if you have any:

  • ear pain
  • discharge from your ear
  • ear infections.

You should also let them know if you notice any other changes in your ears or hearing.

Other information

Going into hospital

If you are admitted to hospital for a reason not related to the cancer, it is important to tell the doctors and nurses that you are having treatment with bisphosphonates. You should tell them the name of your cancer specialist. This is so they can talk to them for advice.


Ibandronic acid tablets contain lactose. If you have an intolerance to some sugars, talk to your doctor before taking this treatment


Ibandronic acid is not usually given to people who are pregnant as it may harm a developing baby. If you are pregnant or if you think you might be pregnant or are planning to have a baby, you must tell your doctor as early as possible.


You are advised not to breastfeed while having this treatment, or for some time after treatment ends. This is because the drugs could be passed to the baby through breast milk. 

Your doctor, nurse or pharmacist can give you more information.

Other medicines

Some medicines can affect how this treatment works or be harmful while you are having it. Always tell your cancer doctor, nurse or pharmacist about any drugs you are taking or planning to take, such as: 

About our information

  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert health professionals and people living with cancer.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

The language we use

We want everyone affected by cancer to feel our information is written for them.

We want our information to be as clear as possible. To do this, we try to:

  • use plain English
  • explain medical words
  • use short sentences
  • use illustrations to explain text
  • structure the information clearly
  • make sure important points are clear.

We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.

You can read more about how we produce our information here.

Date reviewed

Reviewed: 01 September 2022
Next review: 01 March 2025
Trusted Information Creator - Patient Information Forum
Trusted Information Creator - Patient Information Forum

Our cancer information meets the PIF TICK quality mark.

This means it is easy to use, up-to-date and based on the latest evidence. Learn more about how we produce our information.