When This Medicine Should Not Be Used:
This medicine is not right for everyone. You should not receive it if you had an allergic reaction to ibandronate.

How to Use This Medicine:
Injectable

• Your doctor will prescribe your dose and schedule. This medicine is given through a needle placed in a vein. This medicine is usually given every 3 months.
• A nurse or other health provider will give you this medicine.
• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
• Missed dose: Call your doctor or pharmacist for instructions.

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 medicines can affect how ibandronate works. Tell your doctor if you are using any of the following:
  
  • Cancer medicines or radiation treatment
  • NSAID pain or arthritis medicine (including aspirin, celecoxib, diclofenac, ibuprofen, naproxen)
  • Steroids (including dexamethasone, hydrocortisone, methylprednisolone, prednisolone, prednisone)

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, a vitamin D deficiency, or a history of cancer. Tell your doctor if you have dental problems or if you wear dentures.
• This medicine may cause the following problems:
  
  • Low calcium levels
  • Kidney problems
  • Increased risk for a thigh bone fracture
• Tell any doctor or dentist who treats you that you are using this medicine. This medicine could cause jaw problems, especially if you have a tooth pulled or have other dental work.
• This medicine may interact with the dye used for bone scans.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.

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
• Change in how much or how often you urinate, blood in your urine, lower back or side pain
• Muscle spasms or twitching, tingling or numbness in your fingers, toes, or around your mouth
• Pain, swelling, numbness, or a heavy feeling in your mouth or jaw, loose teeth, or other tooth problems
• Severe bone, joint, or muscle pain
• Unusual pain in your thigh, groin, or hip

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

• Cough, stuffy or runny nose, sore throat
• Pain, itching, burning, swelling, or a lump under your skin where the needle was placed

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