Ibandronic acid (Bondronat) | Cancer Research UK
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What ibandronic acid is

Ibandronic acid is a type of bisphosphonate. It is also called Bondronat. Doctors use it to try to prevent bone problems in people whose cancer has weakened the bone. It is most commonly used to treat breast cancer that has spread to the bone (secondary breast cancer).

You may also have ibandronic acid to treat high levels of calcium in the blood (hypercalcaemia) caused by secondary bone cancer.


How you have ibandronic acid

You may have ibandronic acid

As a tablet

You should take the tablet once each day with a full glass of water. Swallow it whole and do not crush, suck or chew it. You need to take the tablet on an empty stomach at least 6 hours after food. So the best time is first thing in the morning before breakfast and before any other medicines or supplements. Take it while you are standing or sitting upright. After taking the tablet do not eat or drink anything (except for water) for at least 30 minutes. You should stay sitting or standing for an hour. 

It is very important that you take tablets according to the instructions your doctor or pharmacist gives you. For example, whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream. You should take the right dose, not more or less. And never stop taking a cancer drug without talking to your specialist first.

Into your vein by drip

Ibandronic acid can go into your bloodstream as a drip (infusion). You have the drip through a fine tube (cannula) in your arm, a central line, a portacath or a PICC line.

You have the drip either

  • For 1 to 2 hours, as a one off treatment to lower the calcium levels in your blood, or
  • For 15 minutes, every 3 to 4 weeks as a treatment to prevent or reduce bone damage

Calcium and vitamin D

For ibandronic acid to work well you need to have good levels of vitamin D and calcium in your body. If you cannot take in enough vitamin D and calcium in your diet, your doctor will prescribe vitamin D and calcium supplements for you.


Tests during treatment

You have blood tests before starting treatment and regularly during your treatment. The tests check the level of calcium in your blood. They also check how well your liver and kidneys are working.


About side effects

We've listed the side effects associated with ibandronic acid below. You can use the links to find out more about each side effect. Where there is no link, please go to our cancer drug side effects section or use the search box at the top of the page.

You may have a few side effects. They may be mild or more severe. A side effect may get better or worse through your course of treatment. Or more side effects may develop as the course goes on. This depends on

  • How many times you've had the drug before
  • Your general health
  • The amount of the drug you have (the dose)
  • How you have the drug (whether by drip or as a tablet)

The side effects may be different if you are having ibandronic acid with other drugs.

Tell your doctor or nurse straight away if any of the side effects get severe.


Common side effects

More than 10 in every 100 people have one or more of these.

  • A high temperature (fever)
  • Low levels of calcium in your blood (hypocalcaemia) – you will have blood tests to check the levels of calcium and other minerals such as potassium, phosphate and magnesium. Usually, the blood test picks up any imbalance before you have any symptoms. A low calcium level can cause changes in sensation so you may have tingling or burning in your lips and tongue
  • Irritation of the food pipe (oesophagus) can be a side effect of taking ibandronic acid tablets – tell your doctor if you already have a condition of your oesophagus or if you develop pain or difficulty swallowing
  • Lowered sensitivity of the skin
  • Headaches or dizziness
  • Bone pain when you first start treatment – you may need stronger painkillers until the pain improves

Occasional side effects

Between 1 and 10 in every 100 people have one or more of these.

  • Low levels of white blood cells may make you more prone to infections than normal
  • Thrush in the mouth
  • Feeling or being sick is usually mild, and you can take anti sickness medicines to control it
  • Tummy pain (abdominal pain) can occur when taking ibandronic acid tablets
  • Indigestion can occur when taking the tablets
  • Taste changes
  • Changes in parathyroid hormone levels
  • Cataract (clouding of the lens of the eye) – let your doctor or nurse know if you have any eyesight changes or can't see in bright light
  • Heart changes, which usually go back to normal when the drug is stopped
  • Skin changes – you may have a rash or bruising
  • Diarrhoea
  • Flu like symptoms, including chills, headaches and aching muscles can occur when taking ibandronic acid tablets – this doesn’t usually last for more than a couple of days
  • Redness and pain at the injection site
  • Inflammation of the bladder or vagina – let your doctor or nurse know if you have any soreness, pain or difficulty when passing urine
  • Non cancerous lumps in the skin
  • Low levels of red blood cells (anaemia) leading to breathlessness and tiredness
  • Difficulty sleeping (insomnia)
  • Mood changes
  • Loss of fertility – you may not be able to become pregnant or father a child after treatment with this drug. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment
  • Smell changes, such as smelling odours that are not present
  • Muscle tension
  • Tooth problems
  • Sensation of your heart beating fast (palpitations)
  • Liver changes that are very mild and unlikely to cause symptoms – they will almost certainly go back to normal when treatment is finished
  • Mouth ulcers
  • Difficulty swallowing
  • Hearing loss
  • Gallstones
  • Hair thinning

Rare side effects

Fewer than 1 in 100 people have these.

  • Kidney changes – you will have regular blood tests to check how well your kidneys are working
  • Damage to the jaw bone (osteonecrosis) can be a side effect of taking bisphosphonates for longer than a year – have a dental check up before you start treatment and tell your dentist that you are having ibandronic acid. Ask your doctor or specialist nurse to advise you about how to keep your mouth clean
  • Fractures at the top of the thigh bone (femur) – let your doctor or nurse know if you have any pain in the top of the leg, your groin, or your hip
  • Inflammation of the eye – tell your doctor or nurse if you have sore or red eyes

Important points to remember

Talk to your doctor, pharmacist or nurse about all your side effects so they can help you manage them. They can give you advice or reassure you. Your nurse will give you a contact number to ring if you have any questions or problems. If in doubt, call them.

Other medicines

Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and over the counter remedies. Some drugs can react together.

Pregnancy and contraception

This drug may harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment with this drug and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.


Do not breastfeed during this treatment because the drug may come through in the breast milk.

Lactose and ibandronic acid

Ibandronic acid tablets contain lactose (a type of sugar). Tell you doctor if you have a rare hereditary syndrome that causes lactose intolerance.


Related information


More information on ibandronic acid

This page does not list all the very rare side effects of this treatment that are very unlikely to affect you. For further information look at the Electronic Medicines Compendium website at www.medicines.org.uk.

If you have a side effect not mentioned here that you think may be due to this treatment you can report it to the Medicines Health and Regulatory Authority (MHRA) at www.mhra.gov.uk.

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Updated: 30 January 2014