Bondrova Pro 150mg+600mg+400IU Tablet

✔️ Pharmacology

Ibandronic Acid:

• Inhibits osteoclast-mediated bone resorption.
• Affinity for hydroxyapatite in bone tissue helps reduce bone turnover and increase bone mass.

Coral Calcium and Vitamin D3:

• Coral Calcium: Contains calcium carbonate with trace minerals and ensures better absorption due to its structural similarity to human bone calcium.
• Vitamin D3: Facilitates calcium absorption from the gastrointestinal tract and helps maintain calcium balance.

✔️ Overdose Management

• Ibandronic Acid: Overdose may result in hypocalcemia, hypophosphatemia, and GI symptoms. Treat with milk or antacids to bind Ibandronate; avoid inducing vomiting due to the risk of esophageal irritation.
• Calcium and Vitamin D3: Symptoms of overdose include hypercalcemia and hypercalciuria; manage by discontinuing therapy and ensuring hydration.

✔️ Side Effects

Ibandronic Acid:

• Common: Hypertension, dyspepsia, nausea, diarrhea, abdominal pain, back pain, arthralgia, myalgia, muscle cramps, influenza, nasopharyngitis, headache, dizziness, and insomnia.
• Rare: Jaw osteonecrosis, esophageal irritation.

Calcium and Vitamin D3:

• Common: Flatulence, diarrhea, constipation, upper GI discomfort.
• Rare: Hypercalcemia and hypercalciuria with prolonged use.

✔️ Dosage & Administration

Ibandronic Acid:

• Adult dose: 150 mg tablet taken once monthly on the same date.
• Take on an empty stomach at least 60 minutes before food, drink (other than water), or other medications.
• Swallow whole with a glass of plain water in an upright position; do not chew or suck the tablet. Avoid lying down for 60 minutes after ingestion.

Calcium and Vitamin D3:

• Take one tablet twice daily (morning and evening) after meals on days 2-31.
• Follow the sequence on the blister strip to track doses.

Pediatrics: Not recommended for children due to lack of established safety and efficacy.

Missed Dose: If you miss a dose, take it as soon as possible unless it is close to the next scheduled dose. Do not double doses.

✔️ Drug Interactions

Ibandronic Acid:

• Absorption may be reduced by-products containing calcium, magnesium, iron, or aluminum (e.g., milk, and antacids).
• Interacts with H2 blockers (e.g., ranitidine).

Calcium and Vitamin D3:

• Calcium reduces the absorption of tetracycline and fluoride; and maintains a 3-hour gap.
• Thiazide diuretics reduce calcium excretion; monitor serum calcium levels.
• Phenytoin, barbiturates, and glucocorticoids: May reduce Vitamin D levels.
• Foods like spinach, cereals, and dairy products may reduce calcium absorption.

✔️ Contraindications

Ibandronic Acid:

• Esophageal abnormalities (e.g., strictures or achalasia).
• Inability to remain upright for 60 minutes.
• Hypocalcemia.
• Hypersensitivity to Ibandronic Acid.

Calcium and Vitamin D3:

• Hypersensitivity to components.
• Hypercalcemia, hyperparathyroidism, hypercalciuria, nephrolithiasis, severe renal insufficiency.
• Concomitant Digoxin therapy (requires calcium level monitoring).

✔️ Pregnancy & Lactation

• Pregnancy Category C: Use only if the potential benefit outweighs the potential risk.
• Breastfeeding: Unknown if excreted in human milk; use with caution.

✔️ Precautions & Warnings

Ibandronic Acid:

• GI irritation: Use cautiously in patients with esophageal or upper GI conditions (e.g., Barrett’s esophagus, ulcers).
• Hypocalcemia: Correct before starting therapy.
• Musculoskeletal pain: Severe pain may occur and can be incapacitating.
• Jaw Osteonecrosis: Higher risk in cancer patients undergoing dental procedures.

Calcium and Vitamin D3:

• Monitor calcium levels in patients with renal impairment or a history of renal stones.
• Ensure adequate hydration to reduce the risk of nephrolithiasis.

✔️ Storage Conditions

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