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 hypocalcemia, giant cell tumor of bone with lung metastasis, renal disorder or a potential to develop hypocalcemia.
- 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.)
Precautions while taking this medicine
- In order to prevent hypocalcemia, ingest calcium and vitamin D everyday under the instruction of your doctor. If you have difficulty in taking them orally, consult with your doctor.
- Since hypocalcemia may occur without any symptoms, frequent blood test is needed. Keep blood test schedule under the instruction of your doctor.
- Necrosis/osteomyelitis of the jaw bone may occur in the patients who are taking medicines for bone lesion including this medicine or similar medicines (Bisphosphonate). These adverse reactions often related to dental treatment such as tooth extraction. Receive adequate explanation about the following points from your doctor or pharmacist.
(1) Receive dental checkup as needed, and if possible, receive dental treatment such as tooth extraction prior to taking the medicine, after consultation with your doctor.
(2) Maintain your oral hygiene by brushing your teeth while taking this medicine.
(3) Receive dental checkup regularly while taking the medicine.
(4) Inform your dentist that you are taking the medicine when you see a dentist.
(5) Avoid any treatments such as tooth extraction while taking the medicine.
If abnormalities in teeth/jaw (jaw pain, loose teeth or swollen gums) occur, see a dentist/oral surgery specialist immediately.
- If you have a possibility of pregnancy, avoid pregnancy while you are taking this medicine and for a certain period of time after you discontinue this medicine.
Possible adverse reactions to this medicine
The most commonly reported adverse reactions include headache, fatigue, nausea and hypocalcemia. If any of these symptoms occur, consult with your doctor or pharmacist.
The symptoms described below are rarely seen as initial symptoms of the adverse reactions indicated in brackets. If any of these symptoms occur, stop taking this medicine and see your doctor immediately.
- shaking limbs, muscular weakness, convulsion, numbness, arrhythmia [hypocalcemia]
- oral pain, swelling of mouth, redness, loose teeth, numbness of jaw, heavy feeling in jaw, fever, loss of appetite [necrosis of the jaw bone, osteomyelitis of the jaw]
- hoarse voice, swelling around eyes/lips, hives, impaired judgment, palpitation, shortness of breath, breathing difficulty, dullness, impaired mind, hot flush, decreased consciousness, lightheadedness [anaphylaxis]
- pain of thigh or inguinal region [atypical subtrochanteric and diaphyseal femoral fractures]
- local pain or swelling of fractured site, movement disorder [multiple vertebral fractures after discontinuation of the treatment]
- chill, high fever, redness with local pain and fever [serious skin infection]
- thirst, excess intake of fluid, excess output of urine, unable to concentrate, consciousness disorder such as mental confusion, nausea, vomiting, muscle ache [hypercalcemia after discontinuation of the treatment]
The above symptoms do not describe all the adverse reactions to this medicine. Consult with your doctor or pharmacist if you notice any symptoms of concern other than those listed above.