Effects of this medicine

Before using this medicine, be sure to tell your doctor and pharmacist

• If you have previously experienced any allergic reactions (itch, rash, etc.) to any medicines.
  If you have: esophageal transitional disorder, esophagitis, gastric ulcer, duodenal ulcer, hypocalcemia and renal disorder.
  If you cannot keep your upper body raised up for at least 30 minutes at the time of taking the medicine.

• If you are pregnant, possibly pregnant or breastfeeding.

• If you are taking any other medicinal products. (Some medicines may interact to enhance or diminish medicinal effects. Beware of over-the-counter medicines and dietary supplements as well as other prescription medicines.)

Dosing schedule (How to take this medicine)

• Your dosing schedule prescribed by your doctor is ((        to be written by a healthcare professional))

• In general, for adults, take 1 tablet (17.5 mg of the active ingredient) at a time, once a week at the time of rising, with a glass of water (about 180 mL) prior to consuming any beverage or food. Avoid lying down for at least 30 minutes after taking the medicine. Avoid drinking any beverages (including mineral water with particularly high content of calcium, magnesium, etc.) other than water, and do not take any food and other medicines for at least 30 minutes after taking the medicine. Strictly follow the instructions.
• This medicine may irritate your mouth and throat. Avoid chewing and sucking this medicine. Do not take this medicine before going to bed, or while lying in bed.

• If you miss a dose and take nothing to eat or drink by the time when you remembered that you missed a dose, take the missed dose as soon as possible. If you remembered that you missed a dose after you take something to eat and drink, skip the missed dose on the day. Take a dose at the time of rising on the next day. Thereafter, take a dose on a preliminarily scheduled day of the week. You should never take two doses at one time.

• If you accidentally take more than your prescribed dose, consult with your doctor or pharmacist.

• Do not stop taking this medicine unless your doctor instructs you to do so.

Precautions while taking this medicine

• Abnormality in jaw bone may occur in receiving dental treatment such as tooth extraction while taking bisphosphonates including this medicine. You need to receive an adequate explanation about the following points from doctors or pharmacists:
  If possible, receive dental treatment such as tooth extraction prior to taking the medicine, after consultation with your doctor.
  Undergo an oral or dental checkup regularly while taking the medicine.
  Avoid any treatments such as tooth extraction while taking the medicine.
  Keep your mouth clean by brushing of teeth while taking the medicine.
  Inform your dentist that you are taking the medicine when you receive dental treatment.

Possible adverse reactions to this medicine

• chest pain, abdominal pain, difficulty in swallowing, black stool  [upper gastrointestinal disorder]
• nausea, vomiting, loss of appetite, yellowing of the skin or white of the eye  [hepatic dysfunction, jaundice]
• pains in teeth, gingiva and jaw; gingival swelling/pus discharge; loose tooth  [necrosis of the jaw bone, osteomyelitis of the jaw]
• earache, running ears, jam-packed feeling of the ear [osteonecrosis of the external auditory canal ]
• The pain of the thigh or an inguinal region [atypical subtrochanteric and diaphyseal femoral fractures]

Storage conditions and other information

• Keep out of the reach of children. Store away from direct sunlight, heat and moisture.
• Discard the remainder. Do not store them. Ask the pharmacist or medical institution how to discard them.

For healthcare professional use only : Day Month Year