IBANDRONIC ACID SANDOZ 150MG FILM-COATED TABLETS
Active substance(s): IBANDRONIC ACID / IBANDRONIC ACID / IBANDRONIC ACID
Ibandronic acid Sandoz 150 mg Film-coated Tablets
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.
• 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 yours.
• 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 Ibandronic acid is and what it is used for
2. What you need to know before you take Ibandronic acid
3. How to take Ibandronic acid
4. Possible side effects
5. How to store Ibandronic acid
6. Contents of the pack and other information
1. WHAT IBANDRONIC ACID IS AND WHAT IT IS USED FOR
Ibandronic acid belongs to a group of medicines called bisphosphonates. It contains the active substance
Ibandronic acid may reverse bone loss by stopping more loss of bone and increasing bone mass in most
women who take it, even though they won’t be able to see or feel a difference. Ibandronic acid may help
lower the chances of breaking bones (fractures). This reduction in fractures was shown for the spine but not
for the hip.
Ibandronic acid is prescribed to you to treat postmenopausal osteoporosis because you have an
increased risk of fractures. Osteoporosis is a thinning and weakening of the bones, which is common in
women after the menopause. At the menopause, a woman’s ovaries stop producing the female hormone,
oestrogen, which helps to keep her skeleton healthy.
The earlier a woman reaches the menopause, the greater her risk of fractures in osteoporosis. Other things
that can increase the risk of fractures include:
• not enough calcium and vitamin D in the diet.
• smoking, or drinking too much alcohol.
• not enough walking or other weight-bearing exercise.
• a family history of osteoporosis.
A healthy lifestyle will also help you to get the most benefit from your treatment. This includes:
• eating a balanced diet rich in calcium and vitamin D
• walking or any other weight-bearing exercise
• not smoking; and not drinking too much alcohol.
2. WHAT YOU NEED TO KNOW BEFORE YOU TAKE IBANDRONIC ACID
Do not take Ibandronic acid
• If you are allergic to ibandronic acid, or any of the other ingredients of this medicine listed in section 6.
• If you have certain problems with your gullet/food pipe (oesophagus) such as narrowing or difficulty swallowing.
• If you can’t stand or sit upright for at least one hour (60 minutes) at a time.
• If you have, or had in the past low blood calcium, please consult your doctor.
Warnings and precautions
A side effect called osteonecrosis of the jaw (ONJ) (bone damage in the jaw) has been reported very rarely in
the post marketing setting in patients receiving ibandronic acid for osteoporosis. ONJ can also occur after
It is important to try and prevent ONJ developing as it is a painful condition that can be difficult to treat. In
order to reduce the risk of developing osteonecrosis of the jaw, there are some precautions you should take.
Before receiving treatment, tell your doctor/nurse (health care professional) if:
• you have any problems with your mouth or teeth such as poor dental health, gum disease, or a planned
• you don’t receive routine dental care or have not had a dental check up for a long time
• you are a smoker (as this may increase the risk of dental problems)
• you have previously been treated with a bisphosphonate (used to treat or prevent bone disorders)
• you are taking medicines called corticosteroids (such as prednisolone or dexamethasone)
• you have cancer
Your doctor may ask you to undergo a dental examination before starting treatment with Ibandronic acid.
While being treated, you should maintain good oral hygiene (including regular teeth brushing) and receive
routine dental check-ups. If you wear dentures you should make sure these fit properly. If you are under
dental treatment or will undergo dental surgery (e.g. tooth extractions), inform your doctor about your dental
treatment and tell your dentist that you are being treated with Ibandronic acid.
Contact your doctor and dentist immediately if you experience any problems with your mouth or teeth such as
loose teeth, pain or swelling, or non-healing of sores or discharge, as these could be signs of osteonecrosis of
Some people need to be especially careful while they’re taking Ibandronic acid. Talk to your doctor before
taking Ibandronic acid:
• If you have any disturbances of mineral metabolism (such as vitamin D deficiency).
• If your kidneys are not functioning normally.
• If you have any swallowing or digestive problems.
Irritation, inflammation or ulceration of the gullet/food pipe (oesophagus) often with symptoms of severe pain
in the chest, severe pain after swallowing food and/or drink, severe nausea, or vomiting may occur, especially
if you do not drink a full glass of water and/or if you lie down within an hour of taking Ibandronic acid. If you
develop these symptoms, stop taking Ibandronic acid and tell your doctor straight away (see section 3).
Children and adolescents
Do not give Ibandronic acid to children or adolescents below 18 years.
Other medicines and Ibandronic acid
Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.
• Supplements containing calcium, magnesium, iron or aluminium, as they could possibly influence the
effects of Ibandronic acid.
• Acetylsalicylic acid and other non-steroidal anti-inflammatory medicines (NSAIDs) (including ibuprofen,
diclofenac sodium and naproxen) may irritate the stomach and intestine. Ibandronic acid may also do so.
So be especially careful if you take painkillers or anti-inflammatories while you’re taking Ibandronic acid.
After swallowing your monthly Ibandronic acid tablet, wait for 1 hour before taking any other medication,
including indigestion tablets, calcium supplements, or vitamins.
Ibandronic acid with food and drink
Do not take Ibandronic acid with food. Ibandronic acid is less effective if it’s taken with food. You can
drink water but no other drinks. After you have taken Ibandronic acid, please wait for 1 hour before you
can have your first food and further drinks (see 3. How to take Ibandronic acid)
Pregnancy and breast-feeding
Ibandronic acid is for use only by postmenopausal women and must not be taken by women who could still
have a baby. Do not take Ibandronic acid if you are pregnant or breast feeding.
Ask your doctor or pharmacist for advice before taking this medicine.
Driving and using machines
You can drive and use machines as it’s expected that Ibandronic acid has no or negligible effect on your
ability to drive and use machines.
Ibandronic acid contains lactose
If you have been told by your doctor that you cannot tolerate or digest some sugars (e.g. if you have a
galactose intolerance, the Lapp lactase deficiency or have problems with glucose-galactose absorption), talk
to your doctor before taking this medicine.
3. HOW TO TAKE IBANDRONIC ACID
Always take this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you
are not sure.
The recommended dose of Ibandronic acid is one tablet once a month.
Taking your monthly tablet
It is important to follow these instructions carefully. They are designed to help your Ibandronic acid tablet
reach your stomach quickly, so it is less likely to cause irritation.
• Take one Ibandronic acid 150 mg tablet once a month.
• Choose one day of the month that will be easy to remember. You can choose either the same date (such
as the 1st of each month) or the same day (such as the first Sunday of each month) to take your
Ibandronic acid tablet. Choose the date that best fits your routine.
• Take your Ibandronic acid tablet at least 6 hours after you last had anything to eat or drink except water.
• Take your Ibandronic acid tablet
- after you first get up for the day, and
- before you have anything to eat or drink (on an empty stomach).
• Swallow your tablet with a full glass of water (at least 180 ml).
Do not take your tablet with water with a high concentration of calcium, fruit juice or any other drinks. If
there is a concern regarding potentially high levels of calcium in the tap water (hard water), it is advised to
use bottled water with a low mineral content.
• Swallow your tablet whole — do not chew it, crush it or let it dissolve in your mouth.
• For the next hour (60 minutes) after you’ve taken your tablet
- do not lie down; if you do not stay upright (standing or sitting), some of the medicine could leak back
into your oesophagus
- do not eat anything
- do not drink anything (except water if you need it)
- do not take any other medicines.
• After you’ve waited for an hour, you can have your first food and drink of the day. Once you’ve eaten, it’s
OK to lie down if you wish, and to take any other medication you need.
Continuing to take Ibandronic acid
It’s important to keep taking Ibandronic acid every month, as long as your doctor prescribes it for you. After 5
years of using Ibandronic acid, please consult with your doctor whether you should continue to take
If you take more Ibandronic acid than you should
If you’ve taken more than one tablet by mistake, drink a full glass of milk and talk to your doctor straight
Do not make yourself vomit, and do not lie down - this could cause Ibandronic acid to irritate your oesophagus.
If you forget to take Ibandronic acid
If you forget to take your tablet on the morning of your chosen day, do not take a tablet later in the day.
Instead, consult your calendar and find out when your next scheduled dose is:
• If you forgot to take your tablet on your chosen day and if your next scheduled dose is only
1 to 7 days away
Never take two Ibandronic acid tablets within the same week. You should wait until the next scheduled
dose is due and take it as normal; then, continue taking one tablet once a month on the scheduled days
you’ve marked on your calendar.
• If you forgot to take your tablet on your chosen day and if your next scheduled dose is more than
7 days away
You should take one tablet the next morning after the day you remember; then, continue taking one tablet
once a month on the scheduled days you’ve marked on your calendar.
4. POSSIBLE SIDE EFFECTS
Like all medicines, this medicine can cause side effects, although not everybody gets them.
Talk to a nurse or a doctor straight away if you notice any of the following serious side effects - you
may need urgent medical treatment:
Uncommon (may affect up to 1 in 100 people)
• severe pain in the chest, severe pain after swallowing food or drink, severe nausea, or vomiting, difficulty in
swallowing. You may have a severe inflammation of your gullet/food pipe, possibly with sores or
constriction of the gullet/food pipe
Rare (may affect up to 1 in 1000 people):
• itching, swelling of your face, lips, tongue and throat, with difficulty breathing.
• persistent eye pain and inflammation
• new pain, weakness or discomfort in your thigh, hip or groin. You may have early signs of a possible
unusual fracture of the thigh bone
Very rare (may affect up to 1 in 10,000 people):
• pain or sore in your mouth or jaw, You may have early signs of severe jaw problems (necrosis (dead bone
tissue) in the jaw bone)
• serious, potentially life-threatening allergic reaction
• severe adverse skin reactions
• 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.
Other possible side effects
Common (may affect up to 1 in 10 people):
• heartburn, discomfort in swallowing, stomach or tummy pain (may be due to an inflammation of the
stomach), indigestion, nausea, having diarrhoea (loose bowels)
• muscle cramps, stiffness of your joints and limbs
• flu-like symptoms, including fever, shaking and shivering, feeling of discomfort, bone pain and aching muscles
and joints. Talk to a nurse or doctor if any effects become troublesome or last more than a couple of days
Uncommon (may affect up to 1 in 100 people)
• flatulence (farting, feeling bloated)
• back pain
• feeling tired and exhausted
• asthma attacks
Rare (may affect up to 1 in 1000 people):
• inflammation of the duodenum (first section of the bowel) causing stomach pain
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 (www.mhra.gov.uk/yellowcard).
By reporting side effects you can help provide more information on the safety of this medicine.
5. HOW TO STORE IBANDRONIC ACID
Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date which is stated on the blister and carton after “EXP”. The expiry
date refers to the last day of that month.
This medicinal product does not require any special storage conditions.
Do not throw away any medicines via wastewater 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 Ibandronic acid contains
• The active substance is ibandronic acid. One film-coated tablet contains 150 mg of ibandronic acid (as
ibandronate sodium monohydrate).
• The other ingredients are:
tablet core: povidone, cellulose microcrystalline, maize starch pregelatinised, crospovidone, silica colloidal
anhydrous, glycerol dibehenate.
tablet coat: hypromellose, lactose monohydrate, titanium dioxide (E171), macrogol 4000.
What Ibandronic acid looks like and contents of the pack
Ibandronic acid 150 mg film-coated tablets are white, round biconvex tablets.
Ibandronic acid 150 mg film-coated tablets are supplied in a cardboard box containing the appropriate
number (1, 3 or 6 tablets) of PA/Aluminium/PVC-Aluminium foil blisters (alu-alu blister) with an instruction
Not all pack sizes may be marketed.
Marketing Authorisation Holder and Manufacturer:
Marketing Authorisation Holder:
Frimley Business Park, Frimley,
Camberley, Surrey, GU16 7SR, UK.
Lek Pharmaceuticals d.d.
Verovškova 57, 1526 Ljubljana, Slovenia or
S.C. Sandoz, S.R.L. Str.
Livezeni nr. 7A, RO-540472 Targu-Mures, Romania or
Salutas Pharma GmbH
Otto-von-Guericke-Allee 1, 39179 Barleben, Germany or
Dervenakion 6, Pallini 15351, Attikis Greece or
ul. Domaniewska 50 C, 02-672 Warszawa, Poland or
Lek Pharmaceuticals d.d.
Trimlini 2D, 9220 Lendava, Slovenia or
Pharmathen International S.A
Industrial park Sapes, Street block 5, 693 00 Sapes, Prefecture of Rodopi, Greece.
This leaflet was last revised in 08/2016.
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.