Becoral Kit

✔️ Pharmacology

Ibandronic Acid (Ibandronate Sodium Monohydrate) is a nitrogen-containing bisphosphonate that works by inhibiting osteoclast-mediated bone resorption. Its action depends on its strong affinity for hydroxyapatite, a major component of bone’s mineral matrix. Suppressing osteoclast activity it reduces bone resorption and turnover. In postmenopausal women, this results in a gradual increase in bone mass due to a decrease in bone loss.

The combination of Coral Calcium and Colecalciferol (Vitamin D3) provides enhanced calcium absorption. Coral calcium, which contains calcium carbonate along with small amounts of magnesium and trace minerals, is structurally similar to human bone calcium, allowing for better bioavailability. Vitamin D3 facilitates calcium absorption from the gastrointestinal tract and helps maintain calcium balance within the body.

✔️ Dosage & Administration | Becoral Kit

Ibandronic Acid 150 mg: Take one tablet once monthly on the same date each month.

Calcium 500 mg + Vitamin D3 200 IU: Usually, two tablets per day are recommended in divided doses or as directed by your doctor.

Administration guidelines:

Day 1:

Take the Ibandronic Acid tablet on an empty stomach, at least 60 minutes before the first meal, beverage (other than water), or any oral medication/supplement (such as calcium, antacids, or vitamins).

Swallow the tablet whole with a full glass of plain water while standing or sitting upright.

Do not lie down for at least 60 minutes afterward.

Do not chew or suck the tablet.

Days 2–31:

Take one Calcium + Vitamin D tablet in the morning and one in the evening after meals.

Follow the sequence indicated on the blister strip for easier dose tracking.

Use in children: Safety and efficacy have not been established in pediatric patients.
Use only as prescribed by a registered medical practitioner.

✔️ Side Effects | Becoral Kit

Ibandronic Acid:
Commonly reported side effects include hypertension, dyspepsia, nausea, abdominal pain, diarrhea, arthralgia, back pain, myalgia, muscle cramps, headache, dizziness, skin rash, insomnia, and upper respiratory infections.

Calcium + Vitamin D3:
Mild gastrointestinal effects such as flatulence, constipation, diarrhea, and abdominal discomfort may occur. Rarely, long-term use can cause hypercalcemia or hypercalciuria.

✔️ Drug Interaction

Ibandronic Acid:

Absorption may be reduced by products containing calcium, magnesium, aluminum, or iron, including milk, food, and antacids.

Interaction with H₂-blockers (e.g., ranitidine) has been observed in clinical studies.

Calcium + Vitamin D3:

Oral calcium can reduce absorption of tetracycline or fluoride preparations; allow at least 3 hours between doses.

Thiazide diuretics may decrease calcium excretion.

Phenytoin, barbiturates, and glucocorticoids may accelerate vitamin D metabolism.

Foods such as spinach, cereals, and dairy products can reduce calcium absorption.

✔️ Contraindications:

Ibandronic Acid:

Esophageal disorders delaying emptying (e.g., stricture, achalasia)

Inability to sit or stand upright for at least 60 minutes

Hypocalcemia

Known hypersensitivity to ibandronic acid

Calcium + Vitamin D3:

Hypersensitivity to any component

Hypercalcemia, hyperparathyroidism, hypercalciuria, nephrolithiasis, or severe renal insufficiency

Concomitant digoxin therapy (requires careful serum calcium monitoring)

Renal calculi and Zollinger-Ellison syndrome

✔️ Pregnancy & Lactation

Pregnancy: Classified as Category C. Use only if the potential benefits outweigh the possible risks to the mother or fetus.

Lactation: It is unknown whether the components are excreted in breast milk; therefore, use caution when administered to nursing women.

✔️ Precautions & Warnings

Ibandronic Acid:

May irritate the upper gastrointestinal tract; use caution in patients with active GI disorders (e.g., Barrett’s esophagus, gastritis, ulcers).

Correct hypocalcemia and any mineral imbalance before starting therapy.

Musculoskeletal pain (severe or disabling) has been reported.

Osteonecrosis of the jaw may occur, particularly following dental procedures.

Calcium + Vitamin D3:

In mild hypercalciuria, dose reduction is usually sufficient.

Monitor serum calcium in patients with renal impairment or those on long-term therapy.

Encourage adequate fluid intake in individuals with a history of renal stones.

✔️ Storage:

Store below 30 °C, away from light and moisture. Keep out of reach of children.