More from Idrofos
Other strengths and forms by Sun Pharmaceutical (Bangladesh) Ltd.
Indications & Uses
Idrofos is indicated for:
Pharmacology
Ibandronic acid works by slowing down bone breakdown. In laboratory animals, it prevented the bone loss that was artificially triggered by stopping ovarian function, by retinoids, or by tumours and tumour extracts. In young, fast-growing rats, it also slowed the bone breakdown their bodies were doing naturally, so they ended up with more bone mass than untreated animals. Studies in animals show that ibandronic acid is a very strong inhibitor of osteoclast activity (osteoclasts are the cells that break bone down). Even at doses more than 5,000 times the dose used to treat osteoporosis, growing rats showed no sign that their bones were mineralising poorly. Because it is so potent and has such a wide safety margin, it can be given on more flexible schedules, including intermittent treatment with long breaks between courses, at fairly low doses.
Ibandronic acid is a very strong bisphosphonate from the nitrogen-containing group. These medicines act on bone and specifically block osteoclast activity, though they don't stop osteoclasts from being recruited. Ibandronic acid mainly targets bone because it binds very strongly to hydroxyapatite, the mineral that forms the framework of bone. It reduces bone resorption but has no direct effect on bone formation. In postmenopausal women, whose bone turnover has speeded up, it brings the rate back down towards premenopausal levels, so bone mass gradually builds up over time. Whether it is taken daily or intermittently, ibandronic acid lowers bone resorption. This shows up as lower levels of bone turnover markers in the blood and urine, higher bone mineral density (BMD), and fewer fractures.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
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.
Side Effects
The most common side effects of Droniva are indigestion (dyspepsia), nausea, diarrhoea, abdominal pain, muscle aches, headache, and dizziness.
Cautions & Contraindications
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.
Contraindications
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.
Pregnancy & Breastfeeding
Pregnancy: Ibandronic Acid should not be used during pregnancy. Studies in which rats and rabbits were given daily oral doses found no evidence of a direct toxic or teratogenic effect on the fetus, and no adverse effects on development were seen in the F1 offspring of rats. However, reproductive toxicity studies in rats showed the effects typically associated with bisphosphonates as a class, including a reduced number of implantation sites, interference with natural delivery (dystocia), and an increase in visceral variations (renal pelvis ureter syndrome). No specific studies have been carried out for the monthly dosing regimen, and there is no clinical experience with Ibandronic Acid in pregnant women.
Nursing Mothers: Ibandronic Acid should not be used by nursing mothers during lactation. In lactating rats given ibandronic acid intravenously at 0.08 mg/kg/day, the highest concentration of the drug found in breast milk was 8.1 ng/ml, occurring within the first 2 hours after administration. By 24 hours, the concentration in milk and in plasma had become similar, at about 5% of the level measured at the 2 hour mark.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Use in Special Populations
Patients with kidney problems: if the creatinine clearance is 30 ml/min or above (mild or moderate renal impairment), no dose change is needed for Ibandronic Acid. Below 30 ml/min, the doctor should decide whether to give it after weighing the risk and benefit for that particular patient.
Patients with liver problems: no dose change is needed.
Elderly: no dose change is needed.
Children: safety and efficacy have not been established in patients under 18 years of age.
Overdose
There's no specific information on how to treat an overdose of Ibandronic Acid. Taken by mouth, though, an overdose may cause problems in the upper gut, such as upset stomach, heartburn, esophagitis, gastritis or ulcer. Milk or antacids should be given so they bind the Ibandronic Acid. Because the esophagus can be irritated, vomiting should not be induced, and the patient should stay fully upright.
⚠️ In an emergency call 999 or go to the nearest hospital emergency department.
Storage
Store Ibandronic Acid below 30°C, away from light and moisture. Keep it out of the reach of children.
Drug Interactions
Common questions about Idrofos 150 mg
What is Idrofos 150 mg Tablet?
Idrofos 150 mg Tablet is a medicine that contains Ibandronic Acid. It is made by Sun Pharmaceutical (Bangladesh) Ltd. It belongs to the Bisphosphonate preparations group of medicines.
What is Idrofos used for?
Idrofos is used for: Osteoporosis.
What are the side effects of Idrofos?
The most common side effects of Droniva are indigestion (dyspepsia), nausea, diarrhoea, abdominal pain, muscle aches, headache, and dizziness.
Can I take Idrofos during pregnancy or while breastfeeding?
Pregnancy: Ibandronic Acid should not be used during pregnancy. Studies in which rats and rabbits were given daily oral doses found no evidence of a direct toxic or teratogenic effect on the fetus, and no adverse effects on development were seen in the F1 offspring of rats. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
What happens if I take too much Idrofos?
There's no specific information on how to treat an overdose of Ibandronic Acid. Taken by mouth, though, an overdose may cause problems in the upper gut, such as upset stomach, heartburn, esophagitis, gastritis or ulcer. In an emergency call 999 or go to the nearest hospital emergency department.
How should I store Idrofos?
Store Ibandronic Acid below 30°C, away from light and moisture. Keep it out of the reach of children.
Can I take other medicines with Idrofos?
Some medicines can interact with Ibandronic Acid, for example: Ibandronic Acid + Algae Calcium + Vitamin D3, Ibandronic Acid + Coral Calcium + Vitamin D3, Ibandronic Acid & Calcium Orotate, Prednisolone, Aspirin, Tamoxifen. Tell your doctor or pharmacist about every medicine you take.
Do I need a prescription for Idrofos?
Idrofos is a prescription (Rx) medicine. Take it as your doctor advises.