<p>Ibandronic Acid:</p>

<ul>
	<li><strong>Upper Gastrointestinal Adverse Reactions</strong>: Ibandronic acid like other bisphosphonates administered orally may cause local irritation of the upper gastrointestinal mucosa. Because of these possible irritant effects, caution should be used when Ibandronic acid is given to patients with active upper gastrointestinal problems (such as known Barrett&rsquo;s esophagus, dysphagia, other esophageal diseases, gastritis, duodenitis or ulcers).</li>
	<li><strong>Hypocalcaemia and Mineral Metabolism</strong>: Treat hypocalcemia and other disturbances of bone and mineral metabolism before starting therapy.</li>
	<li><strong>Musculoskeletal Pain</strong>: Severe and occasionally incapacitating bone, joint, and/or muscle pain has been reported in patients taking Ibandronic acid and other bisphosphonates.</li>
	<li><strong>Jaw Osteonecrosis</strong>: Osteonecrosis, primarily in the jaw, has been reported in patients treated with bisphosphonates. Most cases have been in cancer patients undergoing dental procedures, but some have occurred in patients with postmenopausal osteoporosis or other diagnoses.</li>
</ul>

<p>Calcium and Vitamin-D: In mild hypercalciuria reduction of dose is sufficient to return to normal serum Calcium concentration. Plasma and serum Calcium level should be monitored in mild to moderate renal impairment patients and also in case of long term use. Patients with renal stone or with such previous history should be recommended to increase their fluid intake.</p>