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Etidronate Side Effects

For the Consumer

Applies to etidronate: oral tablet

Along with its needed effects, etidronate may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking etidronate:

More common
  • Bone pain or tenderness (increased, continuing, or returning—in patients with Paget's disease)
Less common
  • Bone fractures, especially of the thigh bone
  • Abdominal or stomach pain or burning
  • bloody, black, or tarry stools
  • chest pain
  • chills
  • cough or hoarseness
  • fever
  • general feeling of tiredness or weakness
  • hives
  • lower back or side pain
  • noisy breathing
  • painful or difficult urination
  • pale skin
  • skin rash or itching
  • sore throat
  • sores, ulcers, or white spots on the lips or inside the mouth
  • swelling of the arms, legs, face, lips, tongue, or throat
  • swollen glands
  • tightness in the chest
  • unusual bleeding or bruising
Incidence not known
  • Blistering, peeling, loosening of the skin
  • bone, joint, or muscle pain that is severe and occasionally disabling
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • difficulty in moving
  • difficulty in swallowing
  • discouragement
  • feeling sad or empty
  • heartburn
  • heavy jaw feeling
  • irritability
  • lack of appetite
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • loosening of a tooth
  • loss of interest or pleasure
  • loss of memory
  • pain or burning in the throat
  • pain, swelling, or numbness in the mouth or jaw
  • problems with memory
  • rash with flat lesions or small raised lesions on the skin
  • red irritated eyes
  • red skin lesions, often with a purple center
  • redness or discoloration of the skin
  • seeing, hearing, or feeling things that are not there
  • trouble concentrating
  • trouble sleeping
  • unusual tiredness or weakness
  • vomiting

Get emergency help immediately if any of the following symptoms of overdose occur while taking etidronate:

Symptoms of overdose
  • Abdominal or stomach cramps
  • confusion
  • convulsions
  • difficulty in breathing
  • irregular heartbeats
  • mood or mental changes
  • muscle cramps in the hands, arms, feet, legs, or face
  • numbness and tingling around the mouth, fingertips, or feet
  • shortness of breath
  • tremor

Some side effects of etidronate may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common - at higher doses Incidence not known

For Healthcare Professionals

Applies to etidronate: intravenous solution, oral tablet


Gastrointestinal side effects are more common with higher doses (10 to 20 mg/kg) and may be alleviated by dividing the daily dose.[Ref]

Common (1% to 10%): Diarrhea, nausea
Rare (less than 0.1%): Burning of the tongue
Frequency not reported: Exacerbation of peptic ulcer disease including perforation in a few patients, gastritis
Postmarketing reports: Esophagitis; glossitis, duodenal ulcer[Ref]


Rare (less than 0.1%): Erythema multiforme, alopecia
Frequency not reported: Angioedema, follicular eruption, macular rash, maculopapular rash, pruritus, Stevens-Johnson syndrome, toxic epidermal necrolysis, urticaria[Ref]


Rare (less than 0.1%): Hypersensitivity reactions, including angioedema, urticaria, rash, pruritus[Ref]


Uncommon (0.1% to 1%): Arthropathies (arthralgia and arthritis)
Rare (less than 0.1%): Atypical subtrochanteric and diaphyseal femoral fractures
Frequency not reported: Osteonecrosis of the jaw (ONJ), leg cramps, increased or recurrent bone pain at pagetic sites and onset of pain at previously asymptomatic sites
Postmarketing reports: Bone fracture, osteomalacia[Ref]

At higher doses the incidence of increased or recurrent bone pain at pagetic sites and/or onset of pain at previously asymptomatic sites rise. When therapy continues, pain resolves in some patients but persists in others.[Ref]


Rare (less than 0.1%): Confusion
Postmarketing reports: Depression, hallucination[Ref]

Nervous system

Rare (less than 0.1%): Paresthesia, peripheral neuropathy
Frequency not reported: Headache
Postmarketing reports: Neuropsychiatric events including amnesia[Ref]


Rare (less than 0.1%): Exacerbation of asthma[Ref]


Rare (less than 0.1%): Leukopenia, agranulocytosis pancytopenia[Ref]


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3. Jaworski RC, Gibson M "Mitral and aortic valve abnormalities in a patient with fibrodysplasia ossificans progressiva." Pathology 15 (1983): 325-8

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5. Lourwood DL "The pharmacology and therapeutic utility of bisphosphonates." Pharmacotherapy 18 (1998): 779-89

6. "Product Information. Didronel Tablets (etidronate)." Procter and Gamble Pharmaceuticals, Cincinnati, OH.

7. vanStaa TP, Leufkens H, Abenhaim L, Cooper C "Postmarketing surveillance of the safety of cyclic etidronate." Pharmacotherapy 18 (1998): 1121-8

8. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

9. Jones PB, McCloskey EV, Kanis JA "Transient taste-loss during treatment with etidronate ." Lancet 2 (1987): 637

10. Evans RA, MacDonald D "Diphosphonates and painful feet." Aust N Z J Med 13 (1983): 175-6

11. Evans RA, Dunstan CR, Hills E, Wong SY "Pathologic fracture due to severe osteomalacia following low-dose diphosphonate treatment of Paget's disease of bone." Aust N Z J Med 13 (1983): 277-9

12. Gallacher SJ, Boyle IT, Capell HA "Pseudogout associated with the use of cyclical etidronate therapy." Scott Med J 36 (1991): 49

13. Mautalen C, Gonzalez D, Blumenfeld EL, Santini Araujo E, Schajowicz F "Spontaneous fractures of uninvolved bones in patients with Paget's disease during unduly prolonged treatment with disodium etidronate (EHDP)." Clin Orthop Jun (1986): 150-5

14. Boyce BF, Smith L, Fogelman I, Johnston E, Ralston S, Boyle IT "Focal osteomalacia due to low-dose diphosphonate therapy in Paget's disease." Lancet 1 (1984): 821-4

Some side effects of etidronate may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.