Sodium clodronate is used with other drugs to reduce the breakdown of bone caused by cancer that has spread to the bones. It is also used to treat a high level of calcium in the blood that may occur with some cancers. Sodium clodronate works by slowing bone loss and by decreasing the amount of calcium released from your bones into your blood. This medication belongs to a class of drugs called bisphosphonates.

Read the Patient Information Leaflet if available from your pharmacist before you start taking sodium clodronate and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth without food as directed by your doctor, usually 1 to 2 times a day. Take it on an empty stomach at least 1 to 2 hours before or 1 to 2 hours after eating. The timing depends on the brand you use, so follow the directions for your brand.

Take sodium clodronate with a full glass of plain water (6 to 8 ounces, 180 to 240 milliliters). Do not take it with milk or any other beverage. Swallow this medication whole. After taking this medication, stay fully upright (sitting, standing, or walking) and do not lie down for at least 30 minutes.

Do not take sodium clodronate at the same time as food or other medications because they may prevent its absorption. Take this medication 1 to 2 hours (depending on your brand) before or 1 to 2 hours after taking any products that contain aluminum, calcium, iron, magnesium, or zinc. Some examples include antacids, quinapril, vitamins/minerals, dairy products (such as milk, yogurt), and calcium-enriched juice.

Drink plenty of fluids during treatment with this medication unless otherwise directed by your doctor.

The dosage is based on your medical condition and response to treatment. Do not take more of this medication than prescribed.

Take this medication regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day.

Nausea or diarrhea may rarely occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including:

• new or worsening bone/joint/muscle pain
• new or unusual hip/thigh/groin pain
• mouth/jaw pain
• muscle spasms
• mental/mood changes

Medications similar to sodium clodronate may rarely cause irritation and ulcers in your stomach or esophagus. Get medical help right away if any of these very serious side effects occur:

• new/severe/worsening heartburn
• chest pain
• difficult/painful swallowing
• stomach/abdominal pain
• black/tarry stools
• vomit that looks like coffee grounds

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including:

• rash
• itching/swelling (especially of the face/tongue/throat)
• severe dizziness
• trouble breathing

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Before taking sodium clodronate, tell your doctor or pharmacist if you are allergic to it; or to other bisphosphonates (such as alendronate); or if you have any other allergies. This product may contain inactive ingredients (such as soya lecithin from soybeans found in some brands), which can cause allergic reactions or other problems. Some people who are allergic to peanuts may also be allergic to soy. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of:

• kidney disease
• inability to sit upright or stand for at least 30 minutes
• difficult/painful swallowing
• esophagus/stomach/intestinal problems (such as heartburn, ulcers, colitis)

Some people taking sodium clodronate may have serious jawbone problems. Your doctor should check your mouth before you start this medication. Tell your dentist that you are taking this medication before you have any dental work done. To help prevent jawbone problems, have regular dental exams and learn how to keep your teeth and gums healthy. If you have jaw pain, tell your doctor and dentist right away.

Before having any surgery (especially dental procedures), tell your doctor and dentist about this medication and all other products you use (including prescription drugs, nonprescription drugs, and herbal products). Your doctor or dentist may tell you to stop taking sodium clodronate before your surgery. Ask for specific instructions about stopping or starting this medication.

Tell your doctor if you are pregnant or plan to become pregnant. Sodium clodronate may stay in your body for many years. You should not become pregnant while using sodium clodronate. Sodium clodronate may harm an unborn baby. If you become pregnant, talk to your doctor right away about the risks and benefits of this medication.

It is unknown if this medication passes into breast milk. Consult your doctor before breastfeeding.

See also the How to Use section.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

This medication may interfere with certain lab tests (such as bone imaging tests), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call 1-800-222-1222. Canada residents can call 1-844-764-7669. Symptoms of overdose may include: muscle spasms, mental/mood changes.

Do not share this medication with others.

Eat well-balanced meals that contain adequate calcium and vitamin D. Consult your doctor or pharmacist for more details.

Lab and/or medical tests (such as calcium and other blood mineral levels, kidney/liver function) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.

If you miss a dose, take it as soon as you remember on an empty stomach. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.