Active substance(s): CLODRONATE DISODIUM TETRAHYDRATE / CLODRONATE DISODIUM TETRAHYDRATE / CLODRONATE DISODIUM TETRAHYDRATE
800 mg tablets
Package leaflet: Information for the user
Read all of this leaflet carefully before you
start taking this medicine because it contains
important information for you.
Keep this leaflet. You may need to read it again.
If you have any further questions, ask your
doctor or pharmacist.
R This medicine has been prescribed for you only.
Do not pass it on to others. It may harm them,
even if their signs of illness are the same as
R If you get any side effects, talk to your doctor
or pharmacist. This includes any possible side
effects not listed in this leaflet. See section 4.
What is in this leaflet
1 What Bonefos tablets are and what they are
2 What you need to know before you take
3 How to take Bonefos tablets
4 Possible side effects
5 How to store Bonefos tablets
6 Contents of the pack and other information
1. What Bonefos tablets are and what they
are used for
Bonefos tablets contain sodium clodronate
which belongs to a group of medicines called
bisphosphonates. These medicines help prevent
the loss of calcium from bones.
Bonefos tablets are used to help manage bone
diseases, particularly those associated with cancer.
Bonefos tablets also help maintain normal levels
of calcium in your blood.
2. What you need to know before you take
Do not take Bonefos tablets if:
R you have very poor kidney function
R you are allergic to sodium clodronate, or to
any of the other ingredients of this medicine
(listed in section 6).
R you are already taking another similar
B Tell your doctor if any of these apply to you
and do not take Bonefos.
Warnings and precautions
Talk to your doctor or pharmacist before taking
Your doctor will take special care if:
R you have problems with your kidneys
R you have (or have had) pain, swelling or
numbness of the jaw or a “heavy jaw feeling”
or loosening of a tooth.
B Tell your doctor before you take Bonefos
tablets, if any of these apply to you.
If you are having dental treatment or will
undergo dental surgery, tell your dentist that you
are being treated with a bisphosphonate. Certain
types of dental treatment are not recommended
while taking bisphosphonates.
Other medicines and Bonefos tablets
Tell your doctor if you are taking, have recently
taken or might take any other medicines.
Tell your doctor if you are taking:
R non-steroidal anti-inflammatory drugs to
relieve pain (e.g. ibuprofen or diclofenac)
R antacids or mineral supplements
R a drug called estramustine which is used to
Do not take any other medicines by mouth for
2 hours before and 1 hour after each dose of
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Bonefos tablets with food and drink
It is important that you take your tablets on an
empty stomach (otherwise your body will not
absorb the drug properly).
Except for plain water, do not eat or drink for
2 hours before and 1 hour after each dose. It is
particularly important to avoid drinking milk in
You can drink water whenever you like.
Pregnancy and breastfeeding
Bonefos tablets are not normally given to people
during pregnancy. If you are pregnant, think you
may be pregnant or are planning to have a baby,
ask your doctor or pharmacist for advice before
taking this medicine.
Do not breastfeed while you are taking Bonefos
Driving and using machines
Bonefos tablets have no known effect on your
ability to drive or use machines.
3. How to take Bonefos tablets
You need to take plenty of fluids (such as water)
before, during and after your treatment.
Always take this medicine exactly as your doctor or
pharmacist has told you. Check with your doctor or
pharmacist if you are not sure.
The tablets should be swallowed with plain water.
Tablets may be divided into two halves to help
with swallowing, but the two halves must be taken
at the same time.
Do not crush or dissolve the tablets before you
take them. Never take them with milk because
it reduces the amount of drug that your body can
The daily dosage of Bonefos tablets varies. In most
cases the dose is between 1600mg (2 tablets) and
3200mg (4 tablets) per day. If you have problems
with your kidneys then the daily dosage may be
If you have been prescribed a single daily dose of
Bonefos tablets, it should be taken (preferably in
the morning) on an empty stomach with a glass
of plain water. After using Bonefos tablets, you
should not eat, drink (other than plain water) or
take any other medicines by mouth for 1 hour.
If you have been prescribed a twice daily dose, the
first dose should be taken as recommended above.
The second dose should be taken between meals,
more than 2 hours after and 1 hour before
eating, drinking (other than plain water), or
taking any other medicines by mouth.
If you take more Bonefos tablets than you
B Get medical help immediately and drink
plenty of water. If possible, take your tablets
with you to show the doctor. Your doctor may
want to check the amount of calcium in your
blood and how well your kidneys and liver are
If you forget to take Bonefos tablets
Do not take the missed dose, just take your next
dose at the usual time.
4. Possible side effects
Like all medicines, this medicine can cause side
effects, although not everybody gets them.
The following side effects have been observed
during treatment with Bonefos tablets.
Please turn over B
If you experience any of these serious side effects,
seek immediate medical attention:
R difficulty breathing
allergic skin reactions such as a rash, redness
numbness and tingling sensations around the
mouth and/or in the fingers and toes, muscle
cramps or spasms (in the back, hands and/or
feet) or fits
kidney problems which can be experienced as
feeling generally unwell, a reduced appetite
and you may observe foamy urine
severe kidney damage which may include
symptoms such as weakness or tiredness,
change in frequency of urination and swelling
of the face, arms, legs and abdomen. These
problems are more common when taking some
types of anti-inflammatory drug (most often
diclofenac) at the same time as Bonefos tablets
pain, swelling or numbness of the jaw, a “heavy
jaw feeling” or loosening of a tooth, especially
if you who have been treated in the past with
bisphosphonates such as zoledronate and
severe bone, joint and/or muscle pain that can
start days to several months after starting
treatment with Bonefos tablets
talk to your doctor if you have ear pain,
discharge from the ear, and/or an ear infection.
These could be signs of bone damage in the ear
(osteonecrosis of the external auditory canal)
which could occur very rarely.
Unusual fracture of the thigh bone particularly in
patients on long-term treatment for osteoporosis
may occur rarely. Contact your doctor if you
experience pain, weakness or discomfort in
your thigh, hip or groin as this may be an early
indication of a possible fracture of the thigh bone.
The following side effects are presented by how
often they may occur:
Common side effects (may affect up to 1 in 10
R low calcium levels in the blood without any
symptoms (asymptomatic hypocalcaemia) or
small increases in the levels of liver enzymes,
which can be detected by blood tests
feeling sick or being sick
Rare side effects (may affect up to 1 in 1,000
R low calcium levels in the blood with symptoms
(symptomatic hypocalcaemia) which may
include numbness and tingling sensations
around the mouth and/or in the fingers and
toes, muscle cramps or spasms (in the back,
hands and/or feet) or, less frequently, fits
increased blood levels of a hormone
(parathyroid hormone) or certain enzymes
(alkaline phosphatase) which can be detected by
allergic skin reaction such as a rash, redness or
breathing difficulties (bronchospasm) – if you
have any difficulties breathing seek immediate
Unusual fracture of the thigh bone (particularly
in patients on long-term treatment for
osteoporosis) – contact your doctor if you
experience pain, weakness or discomfort in your
thigh, hip or groin
Other side effects (frequency unknown)
R breathing problems in patients with a condition
called aspirin-sensitive asthma
allergic reaction causing difficulty breathing
- if you have any difficulty breathing seek
immediate medical attention
kidney problems which may include severe
kidney damage and in rare cases fatal kidney
failure have been reported. These problems are
more common when taking some types of antiinflammatory drug (most often diclofenac) at
the same time as Bonefos tablets
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dead tissue in the jaw bone (osteonecrosis of the
jaw) which is mainly seen in patients who have
been treated in the past with bisphosphonates
such as zoledronate and pamidronate.
Symptoms include pain, swelling or numbness
of the jaw, a “heavy jaw feeling” or loosening of
severe bone, joint and/or muscle pain that can
start days to several months after starting
treatment with Bonefos tablets. However, these
symptoms may also be linked to the reason you
are taking Bonefos tablets.
Swelling and irritation of the uvea (the
middle layer of the eye) has been observed
with Bonefos. Swelling or infection of the
conjunctiva (the membrane lining of the
eyelids) has been reported in one patient who
received Bonefos and another biphosphonate at
the same time. To date, swelling and irritation
of the episclera (a thin layer of tissue covering
the sclera, the white outer wall of the eye) and
the sclera, which has been reported with other
biphosphonates, have not been reported with
B Tell your doctor if any side effect gets
serious, or if you get any effects not listed in
Reporting of side effects
If you get any side effects, talk to your doctor or
pharmacist. This includes any possible side effects
not listed in this leaflet.
You can also report side effects directly via
the Yellow Card Scheme at www.mhra.gov.uk/
yellowcard. By reporting side effects, you can help
provide more information on the safety of this
5. How to store Bonefos tablets
Keep this medicine out of the sight and reach of
Do not use this medicine after the expiry date
which is stated on both the carton and on each
blister strip of tablets after EXP. The expiry date
refers to the last day of that month.
Do not store above 25°C.
Do not throw away any medicines via waste water
or household waste. Ask your pharmacist how to
throw away medicines you no longer use. These
measures will help protect the environment.
6. Contents of the pack and other information
What Bonefos tablets contain
The active substance is sodium clodronate.
Each tablet contains 800mg sodium clodronate.
The other ingredients are croscarmellose sodium,
magnesium stearate, silicified microcrystalline
cellulose and stearic acid. Opadry II white
(containing Macrogol (PEG) 3350, Polyvinyl alcohol
(partially hydrolysed), Purified water, Talc, and
Titanium dioxide (E171)).
What Benefos tablets look like and contents of
Pale white, oval-shaped, film-coated tablets
Bonefos Tablets are available in packs of 60 tablets
Marketing authorisation holder:
Berkshire RG14 1JA
This leaflet was last revised in:
Product licence number:
Source: Medicines and Healthcare Products Regulatory Agency
Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.