Ibandronic Acid

My doctor is very keen for me to take monthly Ibandronic Acid tablets of 150mg. My dentist, however is less keen as she said there can be some problems caused by the drug when having dental treatment. I think she referred to teeth that needed to be extracted.

I've been on Pred. for 4 years and am currently trying to reduce the dose, again, and have got down to 12mg. But I'm taking it very slowly as the stiffness in my legs is very persistent.

Can anyone give advice about taking Ibandronic Acid. Is it a good thing or does it bring more of its own problems long term.

Thank you

21 Replies

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  • The received wisdom on here is that all of these bone protectors have potentially serious side effects and should not be taken for over 2 years anyway. Ideally, prior to even considering them you should know if your bones are thinning and whether there is any sign of osteoporosis at all. There seems to be a fashion for GPs to push them quite agressively and yet there have been concerning research studies that suggest that patients experience more bone fractures on them. Your dentist is right in expressing concern about dental treatment involving extraction etc. one of the alarming side effects for me is the so called " rotting jaw" that can occur following major dental surgery.

    My own position is that I would thoroughly research the drugs and only agree to a prescription if I was shown to need it following a DEXA scan of my bone density. There are people on here who have taken, for instance Alendronic Acic without problems. For me the preference is exercise and vit D calcium supplements and a healthy diet, for as long as I am able. Good luck, whatever you do.

  • Hi Sheffield Jane.

    I have been on AA for 2 years now. I have never had trouble with my teeth and take great care of them. Very seldom need even a clean. However, in the past year I have needed fillings and have decay in some of my precious teeth. Dentist is asking if I chew the calcium/vitD supplement as leaving it on my teeth could rot my teeth or do I eat honey etc etc. I don't do any of these things. Beginning to wonder if it's the AA. Is that a possibility?

    Liz

    Thank you for your excellent posts.

  • You do need particularly good dental hygiene when on bisphosphonates, pred and alendronic acid I think. Pred can lead to problems as it may change blood flow in the gums

  • Thank you Sheffieldjane, that is just what my dentist said. I also have a good diet as my husband has been very ill and has needed a carefully chosen diet for a couple of years. And I have plenty of exercise as I walk my dog twice a day. (All be it slowly and with a stick🙄).

    I've made up my mind not to take them. Thank you for all your help. These decisions are always down to the individual but good solid advice helps enormously. 😘

  • Following a bone density scan about 18 months ago, and severe osteoporosis diagnosed, I was first put on AA tablets, which played havoc with my stomach, so stopped them. My dr then put me on Ibandronic Acid Mylan..1 tablet monthly, and I have no problems. Like it that its only monthly and not weekly. Also take Vit D Calcium tablets.My dentist has never made any comment about taking them.

  • Hi,

    As SJ says you should check if you actually need to take it. Many don't, so why add another tablet into the mix.

    However, like Karools16 I did require a bone strengthener and took AA for 4 years. I never had any problems with taking it, teeth or jaw all that time. Went to dentist this week (18 months after coming off AA) and still no problems - actually only had one filling in the last 10 years.

    It's your choice, so get all the info you can to make a decision that's right for you.

  • Thank you. Think I might ask for a test to see if I really need the stuff. Never been offered one.

  • No I don't think most doctors do offer it, if I remember correctly it's recommended to take the medication along with Pred when diagnosed. But now more people who know about it are querying if it's absolutely necessary. Ask for DEXA scan.

    Hopefully you won't need it, but at least you'll know for sure.

  • Thank you. Will do.

  • The BSR recommendations say do a dexascan and give calcium/vit D routinely. If the dexascan shows a need for more than just calcium, then a bisphosphonate. Don't mind if they check - but giving it "just in case" is not good. Even where they say "bisphosphnates for over 65s" that is also not good - I know people in their 70s and 80s with high bone density and increasing it would lead to other problems.

  • I've been taking Alendronic Acid (plus Calcium D3) since being prescribed Prednisolone in 2014 although not given a Dexa scan for another year. The result was borderline, therefore I would suspect it is beneficial for me to take it. My dentist is aware of my medication & the issues with tooth extraction while taking AA; A few months ago he removed a wisdom tooth after xray to confirm it was possible for him to do so. I hadn't realised a broken jaw can be the result! I am just at 5.5mg Prednisolone (where I was a year ago before a flare) and have tried to keep reduction very slow and my plan is to see Dr in a few weeks when at 5mg and ask to come off the AA. I may ask for another bone density scan depending on Drs response. My diet is good I believe and I dog walk but realise I should walk more. I see the Calcium D3 label says "suck or chew" so it's inevitable the tablet will remain in your mouth? It would be great to be off AA!

  • I took it for 4 years with no problem, but then once I was very low on Pred thought I'd probably had enough. GP agreed, but said stay on VitD/Cal - still on now even though off Pred.

  • My crazy doctor expects me to go down to 5,0 5,for two weeks then nowt. 😱at the moment doing 10,15,10. For two weeks.

    When I get down to 10,5,10 I am going to ask for some ones and do it my way. If he um and aars I will say "my body my adrenaline glands. End of 😤 I have been on pred about 6yrs up and down. Now he his very keen to get me off.

    Ronzy. 🌹m

  • I took AA 5 times over first 12 months and caused me severe hip pain. dx pmr june 2016.

    After sucking up knowledge on here I stood ground for bone scan which I had yesterday. Awaiting results. I will make decision once results come in. Keeping everything crossed.

  • Hi Tonysue, I can only tell you about my experience. I had a bone density scan 9 years ago as was told I was osteopaenic. Alendronic acid was offered to me but I declined due to the same reasons you are concerned. However 18 months ago I was diagnosed with GCA put on 60mg daily of prednisolone, omeprazole and vit d and alendronic acid. Am now down to 5mg pred daily having had to go back up to 60mg once during this time, have had no particular problems with my teeth, and a recent bone density scan shows no further deterioration since the last one. Given the high doses of pred my rheumatologist says the results are pleasing and I should soon be able to stop taking the AA. As I said this is only my personal experience but for me if the AA has stopped me being diagnosed with osteoporosis it has been worth it.

  • I have been on pred for 8 years and for half that time I took Alendronic acid. I then began researching the bad side. As a result, I quit - which is really not much good because the drug stays in your body practically for ever. I recently needed tooth extractions as a result of an accident, and had to have them carried out in a specialist hospital. I now belong to the anti camp and certainly would not even consider bisphosphates without a scan......and even then, caution.

  • Thank you. All this information is a great help.

  • Your doctor may be very keen, but do you need it? Have you had a dexascan? I wouldn't take any of them until after I'd had one with justification for need.

    I'd been on pred for over 7 years, my bone density had barely changed at all and is still well in the range where no treatment is required - and for over 4 years I had been at above 10mg.

    A couple of generations of GPs and others have been persuaded that bisphosphonates prevent hip fractures (maybe, but maybe not) and prevention with pred is better than cure. Preferably though, an early dexascan and then a follow-up one 2 years later is far far better. The drug appear to form a hard but more brittle bone and if you take them too long the bone may fracture because of the structure - which is hardly what you want. It has been said for some time they shouldn't be taken for more than 5 years - and that figure is falling, down to 3 years at least.

    Before any bisphosphonates are taken all potentially necessary dental work should be completed first. But I would have to be persuaded there was a very good reason for taking them. I haven't broken anything in 8 years and my bone density is good - people with low density don't have fractures, people with normal density DO have fractures.

  • My doctors seem to think I should take AA just in case. I did fall about a year ago and fractured my sacrum but neither of the doctors I saw mentioned that it might be a reason to take AA.

    Am sticking with Adcal for a while as there are a too many questions about AA.

  • A lot of them do. I don't - and nor do a lot of others!

  • Hello, I am not a promoter of these drugs at all. When you drlll down to how they entered the marketplace who was behind the studies and use after 5 years in most products shows no added benefit you might have a different opinion. I have had a number of patients that had extreme reactions, one ended up in the EMergency room due to the pain. As a pharmacist I am less is best if you can exercise, eat well and supplement without adding more drugs it is better.

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