When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use it if you had an allergic reaction to etidronate, or if you have esophagus problems, trouble swallowing, or osteomalacia (soft bones).

How to Use This Medicine:
Tablet

• Take this medicine in the morning on an empty stomach. Follow the directions exactly to lower the risk of esophagus problems.
• Swallow the tablet whole with a large glass (6 to 8 ounces) of water at least 2 hours before or after you eat.
• Do not lie down for at least 30 minutes after you take this medicine, and do not lie down until after you have eaten.
• If this medicine upsets your stomach, ask your doctor if you can take 2 smaller doses instead of 1 large dose. Do not change your dose without talking to your doctor.
• Paget disease: This medicine may work slowly, so you may not feel better until you have been using it for awhile. Do not stop taking your medicine unless your doctor tells you to.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Some foods and medicines can affect how etidronate works. Tell your doctor if you are using any of the following:
  
  • Blood thinner (including warfarin)
  • Cancer medicines
  • Steroid medicine (including dexamethasone, hydrocortisone, methylprednisolone, prednisolone, prednisone)
• Do not eat or drink anything that has calcium and do not take any medicine that contains aluminum, magnesium, iron, or calcium within 2 hours of the time you take etidronate. This includes milk or milk products, supplements, and antacids.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease, heartburn, anemia, blood clotting problems, ulcers or other stomach or bowel problems, or a history of cancer. Tell your doctor if you have dental problems or you wear dentures.
• This medicine may cause the following problems:
  
  • Damage to your esophagus
  • Increased risk for a thigh bone fracture
• Tell any doctor or dentist who treats you that you are using this medicine. This medicine may cause jaw problems, especially if you have a tooth pulled or other dental work.
• Your doctor will check your progress and the effects of this medicine at regular visits. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blistering, peeling, red skin rash
• Chest pain, heartburn, or burning feeling in your throat
• Muscle spasms or twitching, tingling or numbness in your fingers, toes, or around your mouth
• Pain or difficulty when swallowing
• Pain, swelling, numbness, or heavy feeling in the jaw, loose teeth, or other tooth problems
• Severe bone, joint, or muscle pain
• Unusual or severe stomach pain
• Unusual pain in your thigh, groin, or hip

If you notice these less serious side effects, talk with your doctor:

• Mild bone pain
• Mild diarrhea or nausea

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088