Quodixor 150 Mg Film-Coated Tablets
Package leaflet: information for the user
Quodixor 150mg film-coated tablets
Ibandronic acid
Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.
• Keep this leaflet. You may need to read it again.
• If you have any further questions, ask your doctor or pharmacist.
• This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
• If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet.
What is in this leaflet:
1. What Quodixor is and what it is used for
2. What you need to know before you take Quodixor
3. How to take Quodixor
4. Possible side effects
5. How to store Quodixor
6. Contents of the pack and other information
1. What Quodixor is and what it is used for
Quodixor belongs to a group of medicines called bisphosphonates. It contains the active substance ibandronic acid.
Quodixor may reverse bone loss by stopping more loss of bone and increasing bone mass in most women who take it, even though they won't be able to see or feel a difference. Quodixor may help lower the chances of breaking bones (fractures). This reduction in fractures was shown for the spine but not for the hip.
Quodixor is prescribed to you to treat postmenopausal osteoporosis because you have an increased risk of fractures.
Osteoporosis is a thinning and weakening of the bones, which is common in women after the menopause. At the menopause, a woman's ovaries stop producing the female hormone, oestrogen, which helps to keep her skeleton healthy.
The earlier a woman reaches the menopause, the greater her risk of fractures in osteoporosis. Other things that can increase the risk of fractures include:
• Not enough calcium and vitamin D in the diet.
• Smoking, or drinking too much alcohol.
• Not enough walking or other weight-bearing exercise.
• A family history of osteoporosis.
A healthy lifestyle will also help you to get the most benefit from your treatment. This includes eating a balanced diet rich in calcium and vitamin D; walking or any other weight-bearing exercise; not smoking; and not drinking too much alcohol.
2. What you need to know before you take Quodixor
Do not take Quodixor
• If you are allergic to ibandronic acid, or to any of the other ingredients of Quodixor (listed in section 6).
• If you have certain problems with your gullet/food pipe (oesophagus) such as narrowing or difficulty swallowing.
• If you can't stand or sit upright for at least one hour (60 minutes) at a time.
• If you have, or had in the past, low blood calcium. Please consult your doctor.
Warnings and precautions
Some people need to be especially careful while they're taking Quodixor. Check with your doctor:
• If you have any disturbances of mineral metabolism (such as vitamin D deficiency).
• If your kidneys are not functioning normally.
• If you have any swallowing or digestive problems.
• If you are under dental treatment or will undergo dental surgery, tell your dentist that you are being treated with Quodixor. Irritation, inflammation or ulceration of the gullet/food pipe (oesophagus) often with symptoms of severe pain in the chest, severe pain after swallowing food and/or drink, severe nausea, or vomiting may occur, especially if you do not drink a full glass of water and/or if you lie down within an hour of taking Quodixor. If you develop these symptoms, speak to your doctor straight away (See section 3).
Children and adolescents
Do not give Quodixor to children or adolescents below 18 years.
Other medicines and Quodixor
Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines, especially:
• Supplements containing calcium, magnesium, iron or aluminium, as they could possibly influence the effects of Quodixor.
• Acetylsalicylic acid and other non-steroidal anti-inflammatory medicines (NSAIDs) (including ibuprofen, diclofenac sodium and naproxen) may irritate the stomach and intestine. Bisphosphonates (like Quodixor) may also do so. So be especially careful if you take painkillers or anti-inflammatories while you're taking Quodixor.
After swallowing your monthly Quodixor tablet, wait for 1 hour before taking any other medication, including indigestion tablets or medicine, calcium supplements, or vitamins.
Quodixor with food and drink
Do not take Quodixor with food. Quodixor is less effective if it's taken with food. You can drink water but no other drinks (see section 3. How to take Quodixor).
Pregnancy and breast-feeding
Do not take Quodixor if you're pregnant or breast-feeding. If you're breast-feeding, you may need to stop in order to take Quodixor.
Ask your doctor or pharmacist for advice before taking this medicine.
Driving and using machines
You can drive and use machines as it's expected that Quodixor has no negligible effect on your ability to drive and use machines. Quodixor contains lactose
If you have been told by your doctor that you cannot tolerate or digest some sugars (e.g. if you have a galactose intolerance, the Lapp lactase deficiency or have problems with glucose-galactose absorption), talk to your doctor before taking this medicine.
3. How to take Quodixor
Always take this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure.
The usual dose of Quodixor is one tablet once a month.
Taking your monthly tablet
It's important to follow these instructions carefully. They are designed to help your Quodixor tablet reach your stomach quickly, so it's less likely to cause irritation.
- Take one Quodixor 150mg tablet once a month.
- Choose one day of the month that will be easy to remember. You can choose either the same date (such as the 1st of each month) or the same day (such as the first Sunday of each month) to take your Quodixor tablet. Choose the date that best fits your routine.
- Take your Quodixor tablet at least 6 hours after you last had anything to eat or drink except water.
- Take your Quodixor tablet
- after you first get up for the day, and
- before you have anything else to eat or drink (on an empty stomach).
- Swallow your tablet with a full glass of water (at least 180ml).
Do not take your tablet with water with a high concentration of calcium, fruit juice or any other drinks. If there is a concern regarding potentially high levels of calcium in the tap water (hard water), it is advised to use bottled water with a low mineral content.
- Swallow your tablet whole - do not chew it, crush it or let it dissolve in your mouth.
- For the next hour (60 minutes) after you've taken your tablet
do not lie down; if you do not stay upright (standing or sitting), some of the medicine could leak back into your oesophagus
- do not eat anything
- do not drink anything (except plain water if you need it)
- do not take any other medicines
- After you've waited for an hour, you can have your first food and drink of the day. Once you've eaten, it's OK to lie down if you wish, and to take any other medication you need.
Do not take your tablet at bedtime or before you get up for the day.
Continuing to take Quodixor
It's important to keep taking Quodixor every month, as long as your doctor prescribes it for you. Quodixor can treat osteoporosis only as long as you keep taking it.
If you take more Quodixor than you should
If you've taken more than one tablet by mistake, drink a full glass of milk and talk to your doctor straight away.
Do not make yourself vomit, and do not lie down - this could cause Quodixor to irritate your oesophagus.
If you forget to take Quodixor
If you forget to take your tablet on the morning of your chosen day, do not take a tablet later in the day. Instead, consult your calendar and find out when your next scheduled dose is:
If your next scheduled dose is only 1 to 7 days away...
You should wait until your next scheduled dose is due and take it as normal. Then, continue taking one tablet once a month on the scheduled days you've marked on your calendar.
If your next scheduled dose is more than 7 days away...
You should take one tablet the next morning after the day you remember. Then, continue taking one tablet once a month on the scheduled days you've marked on your calendar.
Never take two Quodixor tablets within the same week.
4. Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them.
Talk to a nurse or a doctor straight away if you notice any of the following serious side effects - you may need urgent medical treatment:
Common (may affect up to 1 in 10 people):
• Flu-like symptoms, including fever, shaking and shivering, feeling of discomfort, bone pain, and aching muscles and joints. Talk to a nurse or doctor if any effects become troublesome or last more than a couple of days.
• Rash. You may be having an allergic reaction to the medicine.
Uncommon (may affect up to 1 in 100 people):
• Severe pain in the chest, severe pain after swallowing food or drink, severe nausea or vomiting, and difficulty in swallowing. You may have a severe inflammation of your gullet/food pipe, possibly with sores or constriction of the gullet/food pipe.
Rare (may affect up to 1 in 1000 people):
• Itching, swelling of your face, lips, tongue and throat, with difficulty breathing.
• Persistent eye pain and inflammation.
• New pain, weakness or discomfort in your thigh, hip or groin. You may have early signs of a possible unusual fracture of the thigh bone.
Very rare (may affect up to 1 in 10,000 people):
• Pain or sore in your mouth or jaw. You may have early signs of severe jaw problems (necrosis [dead bone tissue] in the jaw bone).
• Serious, potentially life-threatening allergic reaction.
Other possible side effects
Common (may affect less than 1 in 10 people):
• Headache.
• Heartburn, discomfort in swallowing, stomach or tummy pain (may be due to an inflammation of the stomach), indigestion, nausea, having diarrhoea (loose bowels).
Uncommon (may affect less than 1 in 100 people):
• Dizziness.
• Flatulence (farting, feeling bloated).
• Back pain.
• Feeling tired and exhausted.
Rare (may affect less than 1 in 1000 people):
• Inflammation of the duodenum (first section of the bowel) causing stomach pain.
• Hives.
If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.
5. How to store Quodixor
Keep this medicine out of the sight and reach of children.
There are no special storage instructions.
Do not use this medicine after the expiry date which is stated on the carton after 'EXP'. The expiry date refers to the last day of that month.
Do not throw away any medicines via wastewater or household waste. Ask your doctor or pharmacist how to throw away medicines you no longer use. These measures will help to protect the environment.
6. Contents of the pack and other information
What Quodixor contains
• The active substance is ibandronic acid. One tablet contains 150mg of ibandronic acid (as sodium monohydrate).
• The other ingredients are:
tablet core: Povidone, cellulose microcrystalline, maize starch pregelatinised, crospovidone, silica colloidal anhydrous, glycerol dibehenate.
tablet coat: Opadry OY-LS-28908 (white II) consisting of: hypromellose, lactose monohydrate, titanium dioxide (E171), macrogol 4000.
What Quodixor looks like and contents of the pack
Quodixor 150mg film-coated tablets are white, round biconvex tablets.
Quodixor 150mg film-coated tablets are supplied in a cardboard box containing the appropriate number (1 or 3 tablets) of PA/Aluminium/PVC- Aluminium foil blisters (alu-alu blister) with an instruction leaflet.
Marketing Authorisation Holder and Manufacturers Marketing Authorisation Holder:
Pharmathen S.A. 6 Dervenakion Str. 153 51 Pallini, Attiki, Greece Manufacturers:
Pharmathen S.A. 6 Dervenakion Str. 153 51 Pallini, Attiki, Greece or
Pharmathen International S.A. Sapes Industrial Park, Block 5, 69300 Rodopi, Greece Distributor:
Aspire Pharma Ltd, Bellamy House, Winton Road, Petersfield, Hampshire, GU32 3HA, United Kingdom This leaflet was last revised in 10/2013
1010123-P83