Ibandronic acid (Bondronat)

Ibandronic acid is a type of bisphosphonate. Doctors use it to treat cancers that affect the bones, most commonly secondary breast cancer

You may also have ibandronic acid to treat high levels of calcium in the blood (hypercalcaemia) caused by secondary bone cancer.

You may have ibandronic acid

• As a tablet
• Into your vein by drip

As a tablet

You should take the tablet with plenty of water – never milk. You need to take it on an empty stomach. So take it at least 30 minutes before you have a meal or drink, or an hour afterwards. First thing in the morning before breakfast is the best time. You should stay sitting or standing afterwards for an hour. You shouldn't suck, crush or chew the tablet.

It is very important that you take tablets according to the instructions your doctor or pharmacist gave you. Whether you have a full or empty stomach, for example, can affect how much of a drug gets into your bloodstream. You should take the right dose, not more or less. And never stop taking a cancer drug without talking to your specialist first.

Into your vein by drip

Ibandronic acid can go into your vein as a drip (infusion). You have the drip through a fine tube (cannula) in your arm, a central line, a portacath or a PICC line.

You have the drip over 1 to 2 hours. It may be given either

• As a one off treatment to reduce calcium levels in your blood, or
• Every 3 to 4 weeks as a treatment to prevent or reduce bone damage

We have listed the possible side effects below. There is general information about bisphosphonates in the cancer treatment section of CancerHelp UK.

• Flu like symptoms, including fever, chills and a headache – this doesn’t usually last for more than a couple of days
• Low levels of calcium in your blood (hypocalcaemia) – you will have blood tests to check the levels of calcium and other minerals such as potassium, phosphate and magnesium. Usually, the blood test picks up any imbalance before you have any symptoms. A low calcium level can cause changes in sensation so you may have tingling or burning in your lips and tongue
• We don't yet know enough about whether ibandronic acid can harm a developing baby – so you should not become pregnant while taking this drug. Discuss contraception with your doctor before you start your treatment if you think that you or your partner could become pregnant
• Feeling or being sick is usually mild, and you can take anti sickness drugs to control it

• Bone pain when you first start treatment – you may need stronger painkillers until the pain improves
• Changes to your bowel function – you may be constipated or have diarrhoea
• Stomach pain
• Redness and pain at the injection site
• Indigestion or heartburn – let your doctor or nurse know if you have this

A few people may have one or more of the following side effects

• Ibandronic acid can cause kidney damage – you will have regular blood tests to check how well your kidneys are working
• Osteonecrosis of the jaw can be a side effect of taking bisphosphonates for longer than a year – have a dental check up before you start treatment and tell your dentist that you are having ibandronic acid. Ask your doctor or specialist nurse to advise you about how to keep your mouth clean
• Irritation of the food pipe (oesophagus) can be a side effect of taking bisphosphonate tablets – tell your doctor if you already have a condition of your oesophagus or if you develop pain or difficulty when swallowing

The side effects above may be mild or more severe. A side effect may get better or worse through your course of treatment, or more side effects may develop as the course goes on. This depends on

• How many times you've had the drug before
• Your general health
• The amount of the drug you have (the dose)
• Other drugs you are having

Talk to your doctor, pharmacist or nurse about all your side effects so that they can help you manage them. Your chemotherapy nurse, clinic or ward nurse will give you a contact number. You can ring if you have any questions or problems. They can give you advice or reassure you. If in doubt, call them.

Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and other over the counter remedies – some drugs can react together.