Ibandronic Acid is a group of medicine called bisphosphonates. It alters the cycle of bone formation and break down in the body. It slows bone loss while increasing bones mass, which may prevent bone fracture. Ibandronic Acid has an affinity for hydroxyapatite crystals in bone and acts as a hydroxyapatite agent. At the cellular level, Ibandronic Acid inhibits osteoclast. The osteoclasts adhere normally to the bone surface but show evidence of reduce active resorption.

Osteoporosis: Human body constantly breaking down old bone and making new bone tissue. If people have osteoporosis, their body breaks down more bones than it forms. So that gradually bone loss occurs and bones become thinner and fragile. This is especially common in women after the menopause. Many people with osteoporosis have no symptom and may not even know that they have it. However, osteoporosis makes them more likely to have fractures, especially in spine, hips and wrists.

This Kit is indicated for the treatment and prevention of osteoporosis in women (especially after menopause) & men. It increases bone mineral density (BMD) and reduces the incidence of vertebral fractures.

One tablet of Ibandronic Acid 150 mg once monthly of the same date of each month is recommended. To maximize the clinical benefit of Ibandronic Acid, two tablets of Calcium Orotate per day are usually recommended in divided dosage.

To maximize absorption and clinical benefit, Ibandronic Acid tablet of this Kit should be taken at least 60 minutes before the first food or drink (other than water) of the day or before taking any oral medication or supplementation, including calcium, antacids, or vitamins.

To facilitate delivery to the stomach and thus reduce the potential for esophageal irritation, Ibandronic Acid tablet should be swallowed whole with a full glass of plain water (250 ml) while the patient is standing or sitting in an upright position. Patients should not lie down for 60 minutes after taking Ibandronic Acid tablet.

Ibandronic Acid 150 mg tablet of this Kit should be taken on the same date of each month (i.e., the patients Ibandronic Acid day)

If the once monthly dose is missed, and the patients next scheduled Ibandronic Acid day is more than 7 days away, the patient should be instructed to take one Ibandronic Acid 150 mg tablet in the morning following the date that it is remembered. The patient should then return to taking one Ibandronic Acid 150 mg tablet every month in the morning of their chosen day, according to their original schedule.

If the once monthly dose is missed, and the patients next scheduled Ibandronic Acid day is only 1 to 7 days away, the patient must wait until the subsequent month’s scheduled Ibandronic Acid day to take their tablet. The patient should then return to taking one Ibandronic Acid 150 mg tablet every month in the morning of their chosen day according to their original schedule.

The Patient must not take two Ibandronic Acid 150 mg tablets within the same week.

Start taking Calcium Orotate tablets from the next day of Ibandronic Acid day (from day-2 and onwards).

Ibandronic Acid: Common side effects include Hypertension, Dyspepsia, Nausea, Diarrhea, Abdominal Pain, Arthralgia, Back Pain, Localized Osteoarthritis, Myalgia, Muscle Cramp, Influenza, Nasopharyngitis, Bonchitis, Urinary Tract Infection, Upper Respiratory Tract Infection, Headache, Dizziness, Skin Rash, Insomnia etc.

Calcium Orotate: Bloating and swelling in the abdomen are common side effects of Calcium Orotate, loss of appetite, upset stomach, constipation, nausea, vomiting, unusual weight loss, mood changes, bone/muscle pain, headache, increased thirst/urination, weakness, unusual tiredness, formation of kidney stones may occur infrequently.

Ibandronic Acid:

• Ibandronic Acid of this Kit may cause local irritation of the upper gastrointestinal mucosa.
• Adequate intake of Calcium is important in all patient hypocalcaemia
• Severe and occasionally incapacitating bone joint, and/or muscle pain has been reported in patients taking Ibandronic Acid.
• Ibandronic Acid is not recommended for use in patients with severe renal impairment (Creatinine clearance of <30 ml/min).

Calcium Orotate: Before taking Calcium Orotate, precaution is needed if the patient is allergic to Calcium Orotate. Any Calcium supplement taken without food may increase the risk of kidney stones. Therefore, it is advisable that Calcium Orotate be taken with food.

Use in Special Populations

Pediatric Use: Safety and effectiveness in pediatric patients have not been established.

Renal and hepatic impaired patient: No dose adjustment is necessary for patients with mild or moderate renal impairment where creatinine clearance is equal to or greater than 30 ml/min. No dose adjustment is required for patients with hepatic impairment.

Pregnancy & Lactation

There are no adequate and well-controlled studies in pregnant women for this kit. This kit should be used during pregnancy only if the potential benefit justifies the potential risk to the mother and fetus. It is not known whether this kit is excreted in human milk. Caution should be exercised when this kit is administered to a nursing woman.