ইঙ্গিত ও ব্যবহার
Osteonil এর জন্য নির্দেশিত:
ডোজ নির্দেশিকা
শুধুমাত্র নির্দেশিকা তথ্য
প্রদর্শিত ডোজগুলি সরকারি উৎসের সাধারণ নির্দেশিকা। ব্যক্তিগতকৃত ডোজের জন্য সর্বদা আপনার ডাক্তার বা ফার্মাসিস্টের পরামর্শ নিন।
Adults:
The recommended dose of ibandronic acid for treatment is one 150 mg film-coated tablet once a month, ideally taken on the same date each month. The tablet should be taken 60 minutes before the first food or drink of the day (other than water) and before any other oral medicine or supplement, including calcium. Swallow the tablet whole with a full glass of plain water (180 to 240 ml) while sitting or standing upright, and do not lie down for 60 minutes afterwards. Plain water is the only drink that should be taken with ibandronic acid; note that some mineral waters contain higher levels of calcium and should not be used. Do not chew or suck the tablet, as this may cause ulceration of the mouth or throat. Patients whose diet does not provide enough calcium or vitamin D should take supplements. If a monthly dose is missed, take one 150 mg tablet the morning after it is remembered, unless the next scheduled dose is due within 7 days; then return to the usual once-monthly schedule on the original date. If the next scheduled dose is within 7 days, skip the missed dose, wait for the next one, and continue taking one tablet once a month as originally planned. Never take two 150 mg tablets within the same week.
পার্শ্বপ্রতিক্রিয়া
The most common side effects of Droniva are indigestion (dyspepsia), nausea, diarrhoea, abdominal pain, muscle aches, headache, and dizziness.
সতর্কতা ও নিষেধাজ্ঞা
Warnings & Precautions
Low blood calcium (hypocalcemia) and other disturbances of bone and mineral metabolism should be treated effectively before Droniva therapy is started. An adequate intake of calcium and vitamin D is important for all patients. Bisphosphonates taken by mouth may irritate the lining of the upper gastrointestinal tract. Because of this possible irritation and the chance of making an existing condition worse, Droniva should be given with caution to patients with active upper gastrointestinal problems, such as known Barrett's esophagus, difficulty swallowing (dysphagia), other diseases of the esophagus, gastritis, duodenitis or ulcers. Adverse experiences such as esophagitis, esophageal ulcers and esophageal erosions have been reported in patients receiving oral bisphosphonates; some cases were severe and required hospitalization, and rarely they involved bleeding or were followed by narrowing (stricture) or perforation of the esophagus. The risk of severe esophageal adverse experiences appears to be greater in patients who do not follow the dosing instructions and/or who keep taking oral bisphosphonates after developing symptoms that suggest esophageal irritation. Patients should pay particular attention to the dosing instructions and be able to follow them. Physicians should be alert to any signs or symptoms that point to a possible esophageal reaction, and patients should be instructed to stop taking Droniva and seek medical attention if they develop difficulty swallowing, pain on swallowing (odynophagia), pain behind the breastbone, or new or worsening heartburn. Although no increased risk was seen in controlled clinical trials, there have been post-marketing reports of gastric and duodenal ulcers with oral bisphosphonate use, some of them severe and with complications. Since NSAIDs and bisphosphonates are both associated with gastrointestinal irritation, caution should be taken when Droniva is used together with these medicines. Osteonecrosis of the jaw (ONJ) has been reported in patients treated with bisphosphonates. Most cases have occurred in cancer patients undergoing dental procedures, but some have occurred in patients with postmenopausal osteoporosis or other diagnoses. Known risk factors for osteonecrosis of the jaw include a diagnosis of cancer, concomitant therapies (for example chemotherapy, radiotherapy or corticosteroids), and co-existing disorders (for example anemia, coagulopathy, infection or pre-existing dental disease). Most reported cases have been in patients given bisphosphonates intravenously, but some have been in patients treated orally. In patients who develop osteonecrosis of the jaw while on bisphosphonate therapy, dental surgery may make the condition worse. For patients who need dental procedures, there are no data available to show whether stopping bisphosphonate treatment reduces the risk of ONJ. The clinical judgment of the treating physician should guide the management plan for each patient, based on an individual assessment of benefit and risk.
নিষেধাজ্ঞা
Ibandronic Acid must not be used in patients who are known to be hypersensitive to ibandronic acid or to any of the excipients. It must also not be used in patients with uncorrected hypocalcemia: as with all bisphosphonates used to treat osteoporosis, any pre-existing hypocalcemia must be corrected before treatment with Ibandronic Acid is started. As with several other bisphosphonates, Ibandronic Acid must not be used in patients with abnormalities of the esophagus that delay esophageal emptying, such as stricture or achalasia. It is also contraindicated in patients who cannot stand or sit upright for at least 60 minutes.