It is also being studied to see if it can help treat cancer (especially breast cancer) that has spread to the bones, usually along with other treatments such as chemotherapy. Researchers are looking to see if it lowers the risk of bone pain, fractures, and other bone problems.

Ibandronate slows the rate at which osteoclasts break down the mineral structure of bone. In women past menopause, this allows new bone to be formed more quickly than it is broken down, which leads to stronger bones. In people with cancer in the bones, this may help slow the growth of tumors in the bone and may lead to fewer problems such as pain and bone fractures.

• If you are allergic to any medicines, dyes, additives, or foods.

• If you have swallowing problems or heartburn. When taken as a tablet, this drug can irritate the esophagus, which could make these worse. You may need to consider getting ibandronate as an intravenous (IV) injection instead of a pill.

• If you have a history of kidney problems. This drug is usually not recommended in people with serious kidney problems.

• If you are planning on having any dental procedures in the near future. This drug has been linked to serious damage of the jawbone in some people, especially if they have had recent dental work (see Precautions below).

• If you have any other medical conditions such as liver disease (including hepatitis), heart disease, congestive heart failure, lung disease, diabetes, gout, or infections. You may need closer monitoring of these conditions while being treated.

• If you are pregnant, trying to get pregnant, or if there is any chance of pregnancy. This drug may cause problems if either the male or female is taking it at the time of conception or during pregnancy. Men and women who could potentially have children and who are taking this drug should use some kind of birth control during treatment. It is important to check with your doctor about what kinds of birth control can be used with this medicine. This drug should not be used during pregnancy.

• If you are breast-feeding. While no studies have been done, this drug may pass into breast milk and affect the baby. Talk with your doctor about the possible risks of breast-feeding while taking this drug.

• If you think you might want to have children in the future. It is not known whether or not this drug can affect fertility. Talk with your doctor about the possible risk with this drug and the options that may preserve your ability to have children.

• About any other prescription or over-the-counter medicines you are taking, including vitamins and herbs.

Aspirin and other non-steroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen, may raise the risk of irritation of the esophagus or stomach in people taking ibandronate tablets.

Use of this drug with chemotherapy and/or steroids may raise the risk of damage to the bones in the jaw.

No other serious interactions are known at this time. But this does not necessarily mean that none exist. Check with your doctor, nurse, or pharmacist about all of your medicines, herbs, and supplements, and whether alcohol can cause problems with this medicine.

No other serious interactions with food are known at this time. Check with your doctor, nurse, or pharmacist about whether some foods may be a problem.

Tell all the doctors, dentists, nurses, and pharmacists you visit that you are taking this drug.

When used to prevent or treat osteoporosis, ibandronate is either taken orally as a tablet or given as an injection into a vein (intravenous, or IV).

Tablets may be taken in a smaller dose (2.5 mg) once a day or in a larger dose (150 mg) once a month. The tablet should be taken first thing in the morning, at least one hour before the first food or drink of the day. It should be taken with a full glass of plain (not mineral) water. To lower the risk of esophagus irritation, people should not lie down for at least one hour after taking this drug.

Ibandronate can also be given as an IV infusion once every 3 months. The infusion itself takes 15 to 30 seconds.

Your doctor may recommend that you take calcium and vitamin D supplements while getting this drug.

If you are getting ibandronate as an injection, your doctor will do blood tests to track your kidney function and may need to delay your dose or even stop it altogether if the results are abnormal.

This drug is usually not used in people who already have serious kidney problems. While this drug has not been shown to have a large effect on kidney function, other bisphosphonates have. Your doctor may do blood tests to track your kidney function closely while you’re being treated and may need to delay or stop treatment if these tests become abnormal. Your doctor may also recommend that you get plenty of fluids while getting this drug to reduce the chance of kidney damage. Tell your doctor or nurse right away if you notice blood in the urine, lowered urine output, increased thirst, nausea, or vomiting.

In rare cases, this drug can damage the bones in the jaw, a condition called osteonecrosis of the jaw (ONJ). Most cases have occurred in people with cancer who were getting chemotherapy and who had recent dental procedures such as tooth extraction. Your doctor may recommend that you get a thorough dental exam before starting treatment with this drug. While you are getting treatment, be sure to check with your doctor before having any dental procedures done.

In rare cases, getting this drug could lead to low blood calcium levels (hypocalcemia). Your doctor will make sure your calcium levels are normal before starting treatment. You may need to get calcium and vitamin D supplements before and during treatment. Possible symptoms of low calcium levels could include muscle spasms or cramps, muscle or joint pains, changes in sensations on the face, hands or feet, confusion, or seizures. Tell your doctor right away if you notice any of these symptoms.

Your doctor will likely test your blood frequently throughout your treatment, looking for possible effects of the drug on blood chemistry levels. Based on the test results, your doctor may need to change your treatment plan.

In rare cases, this drug may cause allergic reactions when the drug is given. Mild reactions may consist of hives or fever and chills. More serious reactions happen rarely, but can be dangerous. Symptoms can include feeling lightheaded or dizzy (due to low blood pressure), fever or chills, hives, nausea, itching, headache, coughing, shortness of breath, or swelling of the face, tongue, or throat. Tell your doctor or nurse right away if you notice any of these symptoms during or after being given the drug.

• none

• diarrhea
• bone or joint pain
• upset stomach
• pain or trouble swallowing
• heartburn
• stomach ulcers
• flu-like symptoms (chills, weakness, headache, muscle aches, diarrhea) with first dose
• muscle aches
• headache
• runny nose
• cough
• shortness of breath
• nausea/vomiting
• loss of appetite
• constipation
• feeling dizzy or faint
• feeling tired
• urinary tract infection
• pain or redness at injection site

• low blood calcium levels (could lead to muscle pain, cramps, or spasms; abnormal sensations on the face, hands, or feet; or seizures)*
• damage to bones in jaw*
• allergic reactions*
• eye irritation or redness

*See "Precautions" section for more detailed information.