WE ARE FRIEND: Ibandronic acid

About ibandronic acid

Type of medicine	Bisphosphonate
Used for	Osteoporosis in women who have passed the menopause Preventing bone damage in patients with breast cancer that has spread to the bone Reducing high levels of calcium in the blood caused by tumours (injection only)
Also called	Bonviva® Bondronat® Iasibon®
Available as	Tablets Injection

Ibandronic acid is used to treat and prevent bone damage which can occur in osteoporosis and in some cancers that have spread to the bone.

Osteoporosis is a bone disease which causes bones to become brittle and fragile, making them prone to breaks and fractures. During our lifetime, old bone is constantly replaced by new bone. After the age of about 45 years, our bones begin to lose density because old bone is being lost faster than new bone can replace it.

Ibandronic acid works on bones to make them stronger by stopping the breaking down of bone and stopping calcium from leaving the bone.

Before taking ibandronic acid

Before taking ibandronic acid make sure your doctor or pharmacist knows:

If you are pregnant, trying for a baby or breast-feeding.
If you have kidney problems.
If you have heart problems.
If you have problems swallowing.
If you find it difficult to sit or stand for at least 60 minutes.
If you are taking other medicines, including those available to buy without a prescription, herbal or complementary medicines.
If you have ever had an allergic reaction to this or to any other medicine.

How to take ibandronic acid

Depending on what you are being treated for, you will either take tablets or be given an injection.
Before beginning treatment, read the manufacturer's printed information leaflet.
If you are taking Bondronat® or Iasibon® tablets:
- Take your dose each morning before the first food or drink of the day (other than water).
- Avoid food or drink for at least 30 minutes after taking the tablet.
- Swallow the tablet whole with a full glass of plain water while standing or sitting in an upright position.
- Do not lie down for 60 minutes after taking the tablet.
- If you forget to take a dose, just take your tablet the next day as usual. Do not take a double-dose to make up for the missed dose.
If you are taking Bonviva® tablets:
- Take your dose on the same morning each month before the first food or drink of the day (other than water).
- Avoid food or drink for at least 60 minutes after taking the tablet.
- Swallow the tablet whole with a full glass of plain water while standing or sitting in an upright position.
- Do not lie down for 60 minutes after taking the tablet.
- If you forget to take a dose, take it on the morning after you remember unless you are due to take your next dose within 7 days. If your next dose is due within 7 days, then skip the missed dose and take the next dose when it is due.

Getting the most from your treatment

Your doctor may recommend that you see your dentist before starting this treatment. This is because this treatment may increase the risk of you developing osteonecrosisof the jaw, which is a disease where the bone is no longer alive and cannot re-form itself. This risk is reduced by having good dental hygiene which means having regular dental check-ups and brushing your teeth regularly.
When you are having any dental treatment, it is important that you tell your dentist that you are being treated with ibandronic acid.
Keep your regular appointments with your doctor so that your progress can be monitored.

Can ibandronic acid cause problems

Along with their useful effects, all medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

Common side-effects - these affect less than 1 in 10 people who take this medicine	What can I do if I experience this
Diarrhoea	Drink plenty of water to replace lost fluids
Indigestion, feeling sick, stomach ache	Eat little and often. Stick to simple foods
Constipation	Try to eat a well-balanced diet containing plenty of fibre and drink 6-8 glasses of water each day
Headache	Ask your pharmacist to recommend a suitable painkiller. If the headache continues, speak with your doctor
Dizziness	Getting up or moving more slowly should help. If you begin to feel dizzy, sit down for a few minutes until the dizziness passes. Make sure your reactions are normal before driving, operating machinery or doing any other jobs which could be dangerous if you were not fully alert
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

Important: if you experience any signs of irritation to your food pipe during treatment with this medicine (such as new or worsening problems with swallowing, pain on swallowing, pain behind your breastbone, or heartburn) you should stop taking these tablets and tell your doctor.

Important: if you experience pain, swelling or numbness of the jaw, a "heavy jaw feeling" or loosening of a tooth, tell your doctor.

Important: if you experience any thigh, hip, or groin pain, tell your doctor as soon as possible.

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

Keep all medicines out of the sight and reach of children.
Make sure that the person prescribing this medicine knows about any other medicines that you are taking. This includes medicines you buy and herbal and homeopathic medicines.
If you buy any medicines check with a pharmacist that they are safe to take with your other medicines.
Before taking this medicine tell your doctor if you have ever had an allergic reaction after taking any medicine.
Never take more than the prescribed dose. If you suspect that you or someone else has 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.
If you are having any treatment like an operation or dental treatment tell the person carrying out the treatment which medicines you are taking.
Always read the printed information leaflet that comes with your medicine.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Never 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.

Osteoarthritis

Osteoarthritis most commonly affects the hips and knees, but can impact other joints such as the fingers. This condition occurs when the cartilage in the joint begins to break down. The degradation of the cartilage leads to inflammation of the joint and alters the shape of the surrounding bone. The bone thickens andosteophytes, or spurs, may form.

Spurs protrude from the joint and cause additional problems with movement. Bones begin to rub together, which leads to pain, discomfort, swelling and a change in movement.

Heberden’s nodes and Bouchard’s nodes are two of the most common manifestations of the disease. These nodes are bony enlargements located in the fingers. Heberden’s nodes are found in the distal (farther away from the body) joints, while Bouchard’s nodes are found in the proximal (close to the body) joints.

Osteoarthritis is most often a result of age and daily wear and tear. However, there are many other possible causes. Excess weight bearing down on the joints can also cause wear and tear on the joints. Inflammatory diseases such as Lyme disease, other forms of arthritis and diabetes can lead to osteoarthritis.

Osteoarthritis is a chronic condition, meaning that their symptoms are long term. The prognosis is not deadly, but it does cause a great deal of pain.

Rheumatoid Arthritis

The next most common form is Rheumatoid Arthritis. Like osteoarthritis, it is a chronic, inflammatory disease. It is considered chronic because the symptoms are long term.

Unlike osteoarthritis, it is classified as an autoimmune disease and the exact cause is unknown.

The immune system will attack the tissue that surrounds the joint in addition to connective tissue in other areas of the body. The lining of the joint, called the synovium, becomes inflamed. Once this happens, the synovium will destroy the cartilage in the joint. This alters the shape of the bone and can lead to bone erosion.

Other symptoms can include joint warmness, fatigue and fever. Heberden’s and Bouchard’s nodes can also be present.

An individual with Rheumatoid Arthritis can have periods of remission between flare ups. There are a few risk factors. They are:

1. Gender. Females are more likely to develop rheumatoid arthritis.
2. Age. It can occur at any age, but is most likely to develop during middle age and late adulthood.
3. Genetics. If any family members have rheumatoid arthritis, your risk increases.
4. Previous joint injury

Rheumatoid arthritis can take years off your life, but the exact number varies among individuals. The long-term effects can greatly alter the quality of life by causing extreme pain, deformities and even heart problems.

Osteoporosis

Osteoporosis is the most common bone disease. It is commonly associated as only affecting women, but it can also occur in men. This condition is caused by a reduction in bone density, which leads to more fragile bones and a higher risk of fractures.

The cycle of bone building and reabsorption slows down around middle adulthood. The old bone is reabsorbed by the body and not enough new bone is formed to replace it. There are three types of osteoporosis: post-menopausal, senile and idiopathic.

Post-menopausal is the type we are most familiar with. This form of osteoporosis is caused by a lack of estrogen, which aids in bone formation.

The second type is called senile osteoporosis in which the onset is age-related and caused by a deficiency in calcium and/or vitamin D.

The final form is idiopathic osteoporosis, and the cause is unknown. Idiopathic osteoporosis can occur in juveniles and men, despite having sufficient levels of hormones, calcium and vitamin D.

There are quite a few risk factors for osteoporosis. They include:

1. Gender: being female makes one much more likely to develop osteoporosis.
2. Family history.
3. Hormone levels. Having reduced hormone levels or a condition like hyperthyroidism elevates your risk for developing osteoporosis.
4. Deficiencies in calcium and vitamin D.
5. Smoking
6. Inactive lifestyle
7. Having osteopenia, which means having low bone density

Fractures and falls are the primary concern with osteoporosis. Medications exist to prevent fractures that are called bisphosphonates. Taking vitamin D and calcium will also be beneficial in preventing calcium and bone loss. Lifestyle changes will also be necessary to avoid falls. This may include using a walker, wheel chair, living with family or getting outside help.

The prognosis for osteoporosis is not deadly, but it does have its challenges. Increase in the likelihood of fractures, especially of the hip, present the greatest obstacle.

Other than fractures, you are most likely to encounter to the above skeletal disorders. Each can alter the shape of your bones. It is important to know the risk factors and if you fall under any of them and make changes if necessary. Family history can also be a factor. Awareness may or may not prevent the onset, but at least you will be ready for it.