মহিলাদের হাড়ক্ষয় রোগের ঔষধ ইবানড্রোনিক এসিড় টেবলেটের ভাল-মন্দ এবং কার্যকারিতা সম্পর্কে কিছু তথ্যাদি :
মজবুত হাড়ের জন্য খাদ্যতালিকায় অবশ্যই
ক্যালসিয়াম সমৃদ্ধ খাবার রাখতে হবে। কম ফ্যাট যুক্ত দুধ
ও দুগ্ধজাত খাবার খেতে হবে প্রতিদিন। দুধ, ডিম, কাঠবাদাম, ক্যালসিয়াম
সমৃদ্ধ সামুদ্রিক মাছ, সবুজ শাকসবজি, ব্রকলি, প্রচুর
পরিমাণে ফলমূল রাখতে হবে খাদ্য তালিকায়। এতে করেই
আপনি পেতে পারেন মজবুত হাড়।
যারা একটানা বসার কাজ করেন তাদের দেহের
হাড়ের ভঙ্গুরতা বৃদ্ধি পায় অন্যান্যদের তুলনায় অনেক বেশি।
যারা
একেবারেই শারীরিক পরিশ্রম করেন না তাদের হাড় অপেক্ষাকৃত নরম ও দুর্বল হয়ে পড়ে
দ্রুতই। শারীরিক ব্যায়াম, খেলাধুলা, নাচ, সাইকেল
চালানো, সাতার কাটা ইত্যাদি বেশ ভালো শারীরিক পরিশ্রম যা
হাড়কে মজবুত করে তোলে এবং হাড়ের ক্ষয়রোধে সহায়তা করে।
দেহে ভিটামিন ডি এর অভাব হলে ক্যালসিয়াম সমৃদ্ধ খাবার খাওয়ার পরেও হাড়ের সমস্যা থেকে মুক্ত থাকা সম্ভব হয় না। তাই হাড়ের সমস্যা ও ক্ষয় রোধ করতে ভিটামিন ডি এর অভাব পূরণ করতে হবে সর্তকভাবে। মাছ, মাছের তেল, দুধ, সয়া দুধ, ফলমূলে রয়েছে ভিটামিন ডি। সূর্যের আলোর মাধ্যমেও দেহের ভিটামিন ডি এর চাহিদা পূরণ সম্ভব।
দেহে ভিটামিন ডি এর অভাব হলে ক্যালসিয়াম সমৃদ্ধ খাবার খাওয়ার পরেও হাড়ের সমস্যা থেকে মুক্ত থাকা সম্ভব হয় না। তাই হাড়ের সমস্যা ও ক্ষয় রোধ করতে ভিটামিন ডি এর অভাব পূরণ করতে হবে সর্তকভাবে। মাছ, মাছের তেল, দুধ, সয়া দুধ, ফলমূলে রয়েছে ভিটামিন ডি। সূর্যের আলোর মাধ্যমেও দেহের ভিটামিন ডি এর চাহিদা পূরণ সম্ভব।
–
হাড় ক্ষয়ের ঔষধ ইবানড্রোনিক এসিড নিয়ে কিছু কথা ;-
( BRONIVA , BONDRONATE , BONE- GUARD, KALORATE KITS ETC BAND NAME )
নামে বর্তমানে বাংলাদেশে ইবাড়্রোনিক এসিড নামক টেবলেটটি পাওয়া যায় ৷ তবে ইনজ্কেশন আকারে ইহা পাওয়া যায় । উপরের brand নামগুলোর মধ্যে bone-guard এবং ক্যালোরেট কিট বাংলা দেশে প্রথমে তৈরি হলেও বর্তমানে অন্যান্য কম্পেনিগুলা এই ঔষধ প্রস্তুত করা আরম্ভ করেছে ৷ মূল্যও অনেক কমে এসেছে বিদেশী তৈরি ঔষধ থেকে ৷ এই ঔষধটি সাধারনত অস্ট্রোপেরোসিস এবং অস্ট্রোকর্ণিয়ারয় আক্রান্ত মহিলা রোগীদের ক্ষেত্রে প্রথমে ব্যবহৃত হলেও বর্তমানে কিছু ডাক্তার অস্ট্রো আর্থাইটিজ বা আর্থরাইটিজ রোগীর ক্ষেত্রেও ব্যবহার করতে দেখা যাচ্ছে ৷ তবে সাধারণত যে সব মহিলার ৪০ / ৪২ বছর বয়সেই মেনোপোজ হয়ে যায় তাদেরকে প্রথমে হরমন রিপ্লেশমেন্ট থেরাপী প্রয়োগ করে রোগীনির ব্লাডে ইষ্টজেন লেভেল ১১/ ১২ এর উপরে রাখাতে চেষ্টা করা হয় ৷ এক্ষেত্রে ডাক্টার ব্যর্থ হলে এরং রো গীর রক্তে ইষ্টজেন লেভেল ৮ এর নিচে চলে গেলে রোগীর শরীরের মেরুদণ্ড ও গলা সহ অন্যান্য স্থানের হাড ক্ষয়প্রাপ্ত হওয়া আরম্ভ হয় । এই ক্ষয় প্রতিরোধ করতে চিকিৎসার প্রয়োজন হয় ।
ডক্তররা তখন রোগীর শরীরের হারের ক্ষয় প্রতিরোধ করতে বাধ্য হয়ে ইবানড্রোনিক এসিড নামক টেবলেট ব্যবহার করেন ৷ এই ঔষধ ব্যবহারের পূর্বে রোগীর কিছু সতর্কমূলক ব্যবস্থা গ্রহন করলে ঔষধের প্বার্শপ্রতিক্ষিয়া বা সইডএফেক্ট কম হয় ৷ সেই তথ্য সহ ইনটারনেট থেকে সংগ্রহ করা আরো কিছু তথ্যাদি নিচে আগ্রহী পাঠকদের উদ্দেশ্য যুক্ত করে দেয়া হলো ৷
বর্তমানে বাজারে ইনচেপ্টা ফার্মেসিউটিক্যাল একটি একবছরের কো্র্সের একটি ইনজেকশন বাজারজাত করেছে ৷ এইটি বছরে একবার ব্যবহার করলেই চলে ৷ তবে একজন ডক্টরের তত্বাবধানে এই ইনজেকশনটি গ্রহণ করতে হয় ৷ ঔষদটির নাম Zoledronic Acid INN , ( Solution for infusion ) 100ml ( 5mg) brand name Zolenic ৷ এই ইনজেকশনটির মূল্য রাখা হয়েছে প্রায় ছয় হাজার টাকার কাছাকাছি ৷ তবে এই ঔষদটি সর্বাধিক একজন রোগীকে ৩ বারের অধিক ব্যবহার না করতে বলা হয়েছে ৷ তবে টেবলেট আকারে ১২ মাসে ১২ বারের পরিবর্তে বছরে এইটি একবার ব্যবহারের জন্যে কম কষ্ট ভোগ করতে হয় রোগীকে ৷ কিত্তু এই ইনজেশনটি নেয়ার আগে ডাক্টারের পরামর্শ অবশ্যই গ্রহণ করতে হবে ৷ কারণ সব রোগীর ইনজেকশনের প্রয়োজন না ও হতে পারে ৷
( sources;- different articles of internate , credited to the writer of these articles )
আজকাল প্রয়াই বয়স্ক মহিলাদের হাডের ক্ষয়রোগ দেখা যাচ্ছে । প্রতিকারে ডাক্তারা একটি নতুন বাজারজাত করা ঔষধ , যার জেনেরিক নাম ইবানড্রোনিক এসিড় ( ১৫০ MG , ৭৫ MG , ৩৭.৫ MG ) হিসেবে বাংলাদেশে বর্তমানে বাজারজাত করা হয়েছে । এটা বিদেশে রোগীরা ১২ মাসের সিঙ্গুল ডোজ ইনজেকশন আকারে ব্যবহার করতে পারেন , তবে এর সাইড এফেক্ট থাকায় বাংলাদেশে ৩০ দিনের , ১৫ দিনের এমনকি ৭ দিনের কম পাওয়ারের ডোজ টেবলেট আকারের ডোজ ব্যবহার করতে ডাক্তাররা রোগীকে উৎসাহিত করেন ।
আমেরিকায় Broniva নামে , ইউরোপে Bondronate নামে এশিয়ায় Bonviva নামে , পাকিস্তানে Bandrova নামে আর বাংলাদেশে Bone- Guard নামে এবং সঙ্গে ৬০টা ক্যালসিয়াম টেবলেট সহ একটি ইবানড্রোনিক ১৫০mg টেবলেট সহ একমাসের ডোজ এর নাম ক্যেলরেট কিট নামে বাজারজাত প্রথমে হয়েছিল । এখন অন্যানা কম্পেনি ও বিভিন্ন নামে বাজারজাত করা আরম্ভ করছে । মূল্য ও অনেক কমে এসেছে ৷ যাদের আর্থিক সংগতি আছে তারা বিদেশের তৈরি টেবলেট খেয়ে থাকেন ৷ তবে ডাক্তারদের মতে মান নাকি দেশী ও বিদেশী ঔষধের একই ৷ কারণ দেশী এবং বিদেশী ঔষধ ব্যবহারর পর Bone Density পরীক্ষায় উভয় রোগীদেরই ফলাফলে তেমন তথাৎ দেখা যাই নি ৷
কিত্তু এই ঔষধটি খাওয়ার আগে এবং পরে কিছু নিয়ম মেনে ঔষধটি ব্যবহার করলে অনেক সাইডএফেক্ট কম হয় । যেমন এই ঔষধটি সকালে ঘুম থেকে জেগেই অন্য কিছু খাওয়ার পূর্বে খেতে হবে । ঔষধটি খাওয়ার পর ১ ঘণ্টা সময় বসে ( মাথা সোজা করে ) বা দাঁড়িয়ে হাটা চলা করে কাটাতে হবে যাত পাকস্তলিতে যদি কারো অতিরিক্ত এসিড উৎপত্তি হয়ে পড়ে তা যাতে গলাদিয়ে মুখের ভিতর এসে না পড়তে পারে সে জন্যে বিছানায় শোয়া যাবে না । আর শরীরের ব্যথা ও এসিডিটি প্রতিরোধে ঔষধ গ্রহণের আগেরদিন রাতে খাওয়ার সঙ্গে সঙ্গে একটি প্যারাসাইটামল ( ৬৬৫mg বা napa extended ) খেতে হবে আর এর পর আরো ঘণ্টাখানেক পরে একটি 4০mg ( omprazole জতিয় ঔষদ ) Losectill , pantobex -40 খেয়ে একটি 10mg ঘুমের ঔষধ Revotril খেয়ে ঘুমিয়ে পড়তে হবে । পরের দিন সকালে ঘুম থেকে উঠেই পানিদিয়ে কুল্লি করে ঔষধটি পানি দিয়ে গিলে খেয়ে ফেলতে হবে । এর পর হাঁটা বসা করে ১ ঘণ্টা সময় কাটিয়ে দিয়ে পরে সকালের নাস্তা সেরে অন্য কাজকর্মে মনোনিবেশ করে ফেললে মন থেকে ঔষধ খাওয়ার অনুভূতি চলে যাবে । এর পরে আর কোনো অসুবিধা হওয়ার কথা নয় ।
নিম্নে ইনটারনেট থেকে সংগ্রহ করা কিছু তথ্যাদি যুক্ত করে আগ্রহীদের জন্যে দেয়া হলো ;-
How does it work?
Bonviva tablets and injection contain the active ingredient ibandronic acid, which is a type of medicine called a bisphosphonate. Bisphosphonates are medicines that prevent the breakdown of bone. Ibandronic acid is also available without a brand name, ie as the generic medicine.
Bone is not a static structure. It is continually shaped, reformed and rebuilt by cells called osteoblasts and osteoclasts. These cells continuously deposit and remove calcium and phophorous, stored in a protein network that makes up the structure of the bone. Old bone is broken down by the osteoclasts and new bone is formed by the osteoblasts.
In women at the menopause, blood levels of the female hormone oestrogen start to decrease. This results in an increase in bone breakdown by the osteoclasts, which can lead to a loss of bone density. Bone loss is particularly rapid for the first 10 years after the menopause and it may lead to the development of osteoporosis – a condition in which the bones become weak and brittle and break (fracture) more easily.
Ibandronic acid is used to treat osteoporosis in women who have passed the menopause. It works by binding very tightly to the bone and preventing the calcium being removed by the osteoclasts. This stops the osteoclasts from breaking down the bone, which helps to keep the bones strong and less likely to break.
In women who have passed the menopause, ibandronic acid has been shown to reduce the risk of breaking a bone in the spine, but it is not known if it is effective at preventing hip fractures.
Bonviva can be administered by mouth or by injection into a vein. If taken by mouth, one Bonviva tablet is taken once a month, preferably on the same date each month. Alternatively, your doctor can give you a Bonviva injection every three months.
As this medicine slows bone turnover and so prevents calcium being rebsorbed from the bones into the blood, it can cause the amount of calcium in your blood to fall too low. If you are having this medicine as a three-monthly injection, you will need to take calcium and vitamin D supplements to prevent this. If you are taking this medicine as a monthly tablet, your doctor will usually only ask you to take supplements if your dietary intake of calcium and vitamin D is low.
Read more: http://www.netdoctor.co.uk/seniors-health/medicines/bonviva.html#ixzz3Lw1GgkHF
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Taking ibandronic acid tablets:
Ibandronic acid
Ibandronic acid
belongs to a group of drugs called bisphosphonates. Bisphosphonates are commonly used to
treat bone thinning (osteoporosis). In certain situations they can help protect
your bones against some of the effects of secondary bone cancer, such as pain and
weakness. Secondary bone cancer occurs when the original (primary) cancer
spreads to form a new tumour (secondary cancer or metastasis) in the
bone.
Ibandronic acid
can be given alongside other cancer treatments. It may be given to women with breast cancer that
has spread to the bones. It can be used to prevent and treat problems caused by
secondary bone cancer and to reduce a raised calcium level in the blood.
When bones are
affected by secondary cancer, increased amounts of calcium (the substance that
helps to build bones) may be released into the blood. A raised level of calcium
in the blood is known as hypercalcaemia. This can cause symptoms such asfeeling sick
(nausea) or being sick (vomiting), tiredness, irritability and sometimes
confusion. Ibandronic acid helps reduce high levels of calcium.
Secondary
cancer in the bones may make them weak, and in some situations they may break
(fracture). Ibandronic acid helps strengthen the bone and reduce the risk of
fractures. It also helps reduce pain in the bones.
Cancer can
affect the bones in different ways, and ibandronic acid is only helpful for
some cancers that affect
the bones. Your doctor or specialist nurse can tell you if it would be helpful
for you.
In normal
bones, two types of cells called osteoclasts and osteoblasts work together
constantly to shape, rebuild and strengthen existing bone:
·
osteoclasts destroy old bone
·
osteoblasts build new bone.
Some
secondary bone cancers produce chemicals that make the osteoclasts work harder.
This means that more bone is destroyed than rebuilt, which leads to weakening
of the affected bone. This can cause pain and means that the bone can fracture
or break more easily.
Ibandronic
acid targets areas of bone where there is cancer and the osteoclast activity is
high. It helps bring the balance of osteoclast and osteoblast activity back to
normal by reducing the activity of the osteoclasts.
This can reduce pain and help strengthen the bone. It also means that less
calcium will be lost from the
bones.
Taking
ibandronic tablets
It’s important
to carefully follow the advice on how to take your tablets. Your doctor, nurse
or pharmacist will explain this to you.
It’s best to
take the tablet first thing in the morning. Make sure that you take it on an
empty stomach - do not eat or drink anything, or take any other medicines,
for at least six hours beforehand. This is because ibandronic acid can attach
itself to certain substances in food, drinks and medicines. If this happens it
may not be absorbed properly and its effectiveness may be reduced as a result.
Swallow the
tablet whole, with a full glass of plain tap water (not bottled mineral water).
You’ll need to sit straight or stand up when you swallow it. This is to make
sure the tablet is washed down well, which prevents it from irritating your
gullet (the tube from your mouth to your stomach).
Stay sitting or
standing for an hour after you’ve taken the tablet. If you’re in bed, prop
yourself up with pillows. Don’t drink (except plain tap water), eat or take any
other medicines for at least an hour after you’ve swallowed the tablet.
Ibandronic
acid usually needs to be taken
for at least six months
before it has its maximum effect. After that it can usually be taken for as long as it is working well for you.
for at least six months
before it has its maximum effect. After that it can usually be taken for as long as it is working well for you.
Some people
have very few side effects while others may experience more. The side effects
described below won't affect everyone who is having ibandronic acid and may be
different if you are having more than one drug.
We have
outlined the most common side effects but haven't included those that are rare
and therefore unlikely to affect you. If you notice any effects that aren't
listed below, discuss them with your doctor or nurse.
Problems
with swallowing or heartburn
This may be
a sign that the drug is irritating your gullet. If you find swallowing painful
or difficult, or if you have heartburn that is new or getting worse, stop
taking ibandronic acid tablets. Let your doctor know as soon as you can.
Flu-like
symptoms
These
include a high temperature, chills and pains in your muscles or joints can
sometimes occur. Let your doctor know if these effects are troublesome. It may
be helpful to take mild painkillers.
Indigestion
and heartburn
Let your
doctor know if this is a problem and if it continues or gets worse. They can
prescribe medicine to help.
If you’ve
had stomach problems before, ibandronic acid can make them worse. Your doctor
will monitor you closely if you’ve had problems with your stomach in the past.
Feeling
sick (nausea) or being sick (vomiting)
This is
usually mild and can be controlled with anti-sickness (anti-emetic) tablets.
Abdominal
(tummy) pain
If you experience
this, let your doctor know if it is severe or if it continues.
Tingling
sensation in lips or tongue
This happens
because of a drop in calcium levels below normal and is usually only temporary.
Your doctor will carry out regular blood tests to monitor the level of calcium
in your blood.
Diarrhoea or constipation
Let your
doctor know if you have diarrhoea or constipation. They
can prescrive medicine to help with this. Remember to drink plenty of fluids.
Headaches
Some people
have headaches with ibandronic acid. Let your doctor know if you are getting
headaches.
Less common side
effects of ibandronic acidBack to top
Increased
pain
Sometimes pain in the affected bone can become worse
for a short time when you start taking ibandronic acid. If this happens, your
doctor can prescribe painkillers for you until it wears off.
Itchy
skin
Ibandronic
acid may make your skin feel itchy.
Feeling
tired
You may feel
more tired than usual. Tell your doctor if this
is a problem.
Taste
changes
You may
notice that food tastes different and that you have a dry mouth.
Changes
in your blood
Ibandronic
acid may cause changes in the blood such as anaemia (a low level of red blood
cells). Your doctor can do blood tests to check this.
Change
in kidney function
Ibandronic
acid can sometimes affect how your kidneys work. This doesn't usually cause any
symptoms, and the effects are generally mild. Your doctor will check how well
your kidneys are working during your treatment by doing regular blood tests.
Jaw problems (osteonecrosis)
A rare side
effect of ibandronic acid is a condition called osteonecrosis of the jaw. This
is when healthy bone tissue in the jaw becomes damaged and dies. Gum disease,
problems with your dentures and some dental treatments (such as having a tooth
removed) can increase the risk of this. So before you start taking the drug
you'll be advised to have a full dental check-up.
A rare side effect of ibandronic acid is a condition called
osteonecrosis of the jaw. This is when healthy bone tissue in the jaw becomes
damaged and dies. Gum disease, problems with your dentures and some dental
treatments (such as having a tooth removed) can increase the risk of this. So
before you start taking the drug you'll be advised to have a full dental
check-up.
During
treatment with bisphosphonates it's very important to look after your teeth by
brushing them regularly and having routine dental check-ups. Always let your
dentist know that you're taking bisphosphonates. Some of the symptoms of osteonecrosis can
include pain, swelling, redness of the gums, loose teeth or a feeling of
numbness or heaviness in your jaw. Tell your cancer specialist and dentist
straight away if you have any of these symptoms.
It is important that you take each tablet of
ibandronic acid in the correct way, as otherwise they can cause irritation and
damage as they are swallowed.
·
Take the tablet first thing in the morning, before you eat any
food or have anything to drink other than water. You should also make sure it
is more than six hours since you last ate food on the previous day.
·
Swallow the tablet whole
- you must not chew, break, or crush the tablet. You must drink a large glassful of water as you take the tablet, and it is important that you take the tablet while you are standing or sitting in an upright position.
- you must not chew, break, or crush the tablet. You must drink a large glassful of water as you take the tablet, and it is important that you take the tablet while you are standing or sitting in an upright position.
·
Continue to sit or stand upright for 60 minutes after taking a
tablet - you must not lie
down during this time.
·
Do not have anything to eat or drink (other than water) for at
least 30 minutes after taking a tablet. If you are taking Bonviva® tablets, you must not eat or drink
anything (other than water) for 60 minutes afterwards. This is because food
stops the tablet from working and makes your treatment much less effective.
Main use
|
Active ingredient
|
Manufacturer
|
Postmenopausal osteoporosis
|
Ibandronic acid
|
Roche
|
How does it work?
Bonviva tablets and
injection contain the active ingredient ibandronic acid, which is a type of
medicine called a bisphosphonate. Bisphosphonates are medicines that prevent
the breakdown of bone. Ibandronic acid is also available without a brand name,
ie as the generic medicine.
Bone is not a static
structure. It is continually shaped, reformed and rebuilt by cells called
osteoblasts and osteoclasts. These cells continuously deposit and remove
calcium and phophorous, stored in a protein network that makes up the structure
of the bone. Old bone is broken down by the osteoclasts and new bone is formed
by the osteoblasts.
In women at the
menopause, blood levels of the female hormone oestrogen start to decrease. This
results in an increase in bone breakdown by the osteoclasts, which can lead to
a loss of bone density. Bone loss is particularly rapid for the first 10 years
after the menopause and it may lead to the development of osteoporosis – a
condition in which the bones become weak and brittle and break (fracture) more
easily.
Ibandronic acid is used
to treat osteoporosis in women who have passed the menopause. It works by
binding very tightly to the bone and preventing the calcium being removed by
the osteoclasts. This stops the osteoclasts from breaking down the bone, which
helps to keep the bones strong and less likely to break.
In women who have
passed the menopause, ibandronic acid has been shown to reduce the risk of
breaking a bone in the spine, but it is not known if it is effective at
preventing hip fractures.
Bonviva can be
administered by mouth or by injection into a vein. If taken by mouth, one
Bonviva tablet is taken once a month, preferably on the same date each month.
Alternatively, your doctor can give you a Bonviva injection every three months.
As this medicine slows
bone turnover and so prevents calcium being rebsorbed from the bones into the
blood, it can cause the amount of calcium in your blood to fall too low. If you
are having this medicine as a three-monthly injection, you will need to take
calcium and vitamin D supplements to prevent this. If you are taking this
medicine as a monthly tablet, your doctor will usually only ask you to take
supplements if your dietary intake of calcium and vitamin D is
low.
What is it used for?
·
Osteoporosis in
women who have passed the menopause.
·
How do I take Bonviva
tablets?
·
It is very important that the instructions for taking Bonviva
tablets are followed completely. This is because when ibandronic acid is taken
by mouth it can cause irritation and ulceration of the foodpipe (oesophagus).
Following the instructions below minimises this risk. If you are unclear about
anything ask your pharmacist for advice.
·
·
Your Bonviva tablet should be taken on the same date each month, in
the morning after an overnight fast (at least six hours) and before the first
food, drink or medicine of the day.
·
·
The tablet should be swallowed whole with a glass of plain water
(180 to 240ml, not mineral water) while you are sitting or standing in an
upright position. Do not crush, chew or suck the tablet.
·
You should not lie down for one hour after taking your Bonviva
tablet.
·
·
You should not eat or drink anything other than plain water for one
hour after taking the tablet. This is because food and some drinks (including
mineral water) can interfere with the absorption of the medicine from the gut
and hence make it less effective.
·
·
You should not take any other medicine by mouth in the six hours
before you take your Bonviva tablet, at the same time as your Bonviva tablet,
or in the hour after you have taken the tablet. See the end of this factsheet
for more details.
·
·
If you forget to take your monthly tablet, you should take it the
morning after you remember, and then return to taking it once a month on your
normal date. However, if you miss a dose but realise that your next dose is due
in the next seven days, forget the missed dose and take your next scheduled
dose on the day you would normally take it. You should not take two tablets
within the same week. You may find it helpful to keep a reminder, eg on a
calendar, of what date you have taken your tablet and what date your next dose
is due.
·
Warning!
·
If you experience any signs of irritation to your foodpipe
during treatment with this medicine, for example new or worsening problems with
swallowing, pain on swallowing, pain behind your breastbone, or heartburn, you should stop taking Bonviva
tablets and inform your doctor.
·
·
Your doctor may want you to have regular blood tests to
monitor your kidney function and the level of calcium in your blood while you
are having treatment with this medicine.
·
·
The class of medicines that ibandronic acid belongs to
(bisphosphonates) has been associated with a rare condition called
osteonecrosis of the jaw. The majority of cases of this condition have been in
cancer patients treated with bisphosphonates by injection into a vein, and many
of these people were also having treatment with chemotherapy or corticosteroids.
However, the condition has also been seen in people taking bisphosphonates by
mouth. The risk may also be increased by poor oral hygiene, dental problems such as gum
disease or poorly fitting dentures, teeth extractions, oral surgery and
smoking. For this reason, you should have a dental examination and, if
necessary, appropriate preventive dentistry, before you start treatment with
this medicine. Discuss this with your doctor. It is important to look after
your mouth and teeth as much as possible while you are taking this medicine.
You should have regular check-ups with your dentist and get advice straight
away if you have any problems with your mouth or teeth. When you see a dentist
during treatment, make sure they know you are taking this medicine. Invasive
dental procedures such as tooth extraction or surgery should be avoided if
possible.
·
·
Some people being treated with bisphosphonates (mainly people
having long-term treatment for osteoporosis) have experienced an unusual
fracture of their thigh bone. For this reason it is important to let your
doctor know if you get any pain in your thighs, hips or groin while you are
having treatment with this medicine. These symptoms could be an early
indication of a possible fracture.
Use with caution in
·
Decreased kidney function.
·
Disorders of the parathyroid gland (gland that produces hormones
responsible for regulating calcium metabolism).
·
Vitamin D deficiency.
·
·
Bonviva tablets should be used with caution in people with
active disorders of the upper part of the digestive system, such as difficulty
swallowing, disorders affecting the foodpipe (eg reflux disease), ulcers, inflammation of the lining of the
stomach (gastritis), inflammation of the small intestine (duodenitis).
·
Not to be used in
·
Children.
·
·
Pregnancy.
·
·
·
People who have a low level of calcium in their blood
(hypocalcaemia).
·
·
Bonviva tablets should not be used in people who have any
abnormality of the foodpipe (oesophagus) that causes difficulty swallowing or
delayed passage of food through the foodpipe, eg narrowing or achalasia of the
foodpipe.
·
·
Bonviva tablets should not be used in people who cannot stand or
sit upright for at least 60 minutes.
·
Bonviva tablets contain lactose and should not be taken people
with rare hereditary problems of galactose intolerance, Lapp lactase deficiency
or glucose-galactose malabsorption.
·
This medicine should
not be used if you are allergic to any of its ingredients. Please inform your
doctor or pharmacist if you have previously experienced such an allergy.
If you feel you have
experienced an allergic reaction, stop using this medicine and inform your
doctor or pharmacist immediately.
·
.
Side effects
Medicines and their
possible side effects can affect individual people in different ways. The
following are some of the side effects that are known to be associated with this
medicine. Just because a side effect is stated here, it does not mean that all
people using this medicine will experience that or any side effect.
·
Low blood calcium level (hypocalcaemia).
·
Flu-like symptoms.
·
Indigestion.
·
Nausea and vomiting.
·
Abdominal pain.
·
Diarrhoea.
·
Bone pain.
·
Pain in the muscles or joints.
·
Feeling of weakness.
·
Headache.
·
Dizziness.
·
Inflammation of the foodpipe (oesophagitis - Bonviva tablets only).
·
Difficulty swallowing (Bonviva tablets only).
·
Inflammation of the stomach (gastritis).
·
Rash.
·
Eye inflammation.
·
Osteonecrosis of the jaw (see warning section above).
·
Unusual fractures of the thigh bone (see warning section above).
The side effects listed
above may not include all of the side effects reported by the medicine's
manufacturer.
For more information about
any other possible risks associated with this medicine, please read the
information provided with the medicine or consult your doctor or pharmacist.
How can this medicine
affect other medicines?
It is important to tell
your doctor or pharmacist what medicines you are already taking, including
those bought without a prescription and herbal medicines, before you start
treatment with this medicine. Similarly, check with your doctor or pharmacist
before taking any new medicines while having treatment with this one, to make
sure that the combination is safe.
Other medicines may
interfere with the absorption of Bonviva tablets from the gut and could
therefore make the medicine less effective. For this reason, you should not
take other medicines by mouth in the six hours before you take your Bonviva
tablet, or in the hour after you have taken the tablet. This is particularly
important for the medicines listed below:
·
antacids (indigestion remedies)
·
calcium supplements
·
iron supplements
·
laxatives containing magnesium
·
mineral supplements
·
multivitamins containing minerals such as calcium, iron, magnesium or zinc
·
zinc supplements.
·
There may be an increased
risk of irritation to the foodpipe (oesophagitis) if non-steroidal
anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, diclofenac or indometacin are taken in combination with Bonviva
tablets. These types of painkiller are best avoided by people taking Bonviva
tablets. Ask your pharmacist for further advice.
There may an increased
chance of the amount of calcium in the blood falling too low if aminoglycoside
antibiotics such as gentamicin are used in combination with this
medicine.
তবে এতে ভয়ের কিছু নেই । যে কোনো সাধারণ ঔষধেও এই রকম অনেক ভয় জাগানো তথ্যাদি ঔষধ কম্পেনিরা তাদের ঔষধেরর লিপলেটে দিয়ে থাকে তাদের নিজেদের স্বার্থেই ৷এতে ভয় পেলে ঔষধ ব্যবহারই বন্ধ করে ফেলতে হবে এ ক্ষেত্রে ক্ষতি থেকে লাভটাই বিবেচনা করে প্রয়োজনীয় ঔষধ অবশ্যই ব্যবহার করা উচিত ৷ ....
some more information of -
Osteoporosis
4 Little-Known Facts About Osteoporosis You Need To Know
According to the National Osteoporosis Foundation, roughly 54 million Americans are affected by osteoporosis and low bone mass.
( source - internate 0
This isn’t a small matter: “This condition causes an estimated two million broken bones each year and often results in immobility, pain, placement in a nursing home, isolation and other health problems,” said executive director and CEO of the National Osteoporosis Foundation, Amy Porter(1).
This problem isn’t just painful for individuals, it’s expensive on a larger scale. In the United States, Medicare – publicly funded healthcare – pays for the repair and treatment of about 80% of the broken bones that are caused by osteoporosis each ear. This puts osteoporosis at number 10 in the top 5% of conditions that are most expensive to Medicare.
But despite its prevalence, most people don’t know that much about this common disease. Here are some little-known facts about osteoporosis and low bone density (or osteopenia) that may surprise you.
1. You Might Have Osteoporosis Or Low Bone Density And Not Know It Yet
Osteoporosis is notoriously difficult to catch in the early stages. “The first sign of osteoporosis is often a bone fracture – and by that point quite a lot of bone tissue has usually already broken down,” one source writes(2).
Known risks for osteoporosis include excessive steroid use(3), long-term restrictive eating disorders(4), a family history of the disease(5). If any of these apply to you, it’s important to be in touch with your doctor regularly about your risk for developing osteopenia or osteoporosis.
2. There Are Medications That Can Help, But Their Use Is Limited
Biphosphonates are a class of drug specifically developed to treat low bone density. These drugs include medications such as Fosamax, Actonel, and Reclast, and they work by inactivating a certain type of bone cell that reabsorbs bone tissue(6). Other medications can actually cause new bone to grow, strengthening your bones that way.
However, the benefits of these drugs do come at a potentially heavy cost. The US Food And Drug Administration has issued numerous warnings about these drugs – they’re directly connected to kidney function impairment, esophageal cancer, chronic pain and atypical fractures(7). And these risks only become more pronounced the longer you take them.
For this reason, there’s a time limit on taking these drugs. “The small benefits of bisphosphonates likely outweigh the harms during the first 3 years of therapy, but harms likely outweigh benefits for durations greater than 3 years,” write researchers at the Therapeutics Initiative(8).
3. Having Low Bone Density Doesn’t Necessarily Mean You Need Medication
If you have osteopenia, there’s a good chance that you don’t need medication – just better nutrition and lifestyle choices.
“Correction of calcium and vitamin D deficiency and walking 3 to 5 miles a week can often improve bone density in the hip and spine,” write the authors of a 2010 paper on the diagnosis and treatment of osteopenia(9).
4. You Can Prevent Osteoporosis With Diet
While calcium, vitamin D, and getting plenty of exercise are all important for promoting bone health and preventing osteopenia and osteoporosis, they’re not the only things you need to be conscious of.
Known risks for osteoporosis include excessive steroid use, long-term restrictive eating disorders, a family history of the disease. If any of these apply to you, it’s important to be in touch with your doctor regularly about your risk for developing osteopenia or osteoporosis.
“In addition to dairy, fruit and vegetable intake has emerged as an important modifiable protective factor for bone health,” one study reports. “Several nutrients, including magnesium, potassium, vitamin C, vitamin K, several B vitamins, and carotenoids, have been shown to be more important than previously realized.”(10)
In addition to this, “Regular intake of cola beverages shows negative effects and moderate alcohol intake shows positive effects on bone, particularly in older women.” So put down the large soda and don’t feel as guilty about the occasional glass of wine.
sources:
- [1]http://nof.org/news/2948
- [2]http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072714/
- [3]http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1753875/
- [4]http://www.ncbi.nlm.nih.gov/pubmed/21360368
- [5]http://www.ncbi.nlm.nih.gov/pubmed/18541176
- [6]http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2667901/
- [7]http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm101551.htm
- [8]http://www.ti.ubc.ca/letter84
- [9]http://www.ncbi.nlm.nih.gov/pubmed/21234807
- [10]http://www.ncbi.nlm.nih.gov/pubmed/19968914
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