Tiludronate (patient information)

# Why is this medication prescribed
Tiludronate, a biphosphonate, is used to treat Paget's disease. It slows the weakening of bone by decreasing the breakdown of bone.
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

# How should this medicine be used
Tiludronate comes as a tablet to take by mouth. It should be taken once a day on an empty stomach. Do not remove tablets from the foil strip until you are ready to take them. Tiludronate should be taken with a full glass (6-8 ounces) of plain water. Wait at least 2 hours before eating, drinking, or taking other medications. Do not take tiludronate with mineral water, coffee, orange juice, grapefruit juice, milk, or other dairy products.
Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take tiludronate exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Your doctor will probably prescribe tiludronate for 3 months. Do not stop taking tiludronate without talking to your doctor.

# What special precautions should I follow
Before taking tiludronate
- tell your doctor and pharmacist if you are allergic to tiludronate, alendronate, clodrinate, etidronate, risendronate, pamidronate, or any other drugs.
- tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially antacids (such as aluminum hydroxide , magnesium oxide , or aluminum magnesium ); aspirin products (such as aspirin or diflunisal ); calcium products; indomethacin (Indocin); mineral or vitamin supplements containing calcium, iron, magnesium, or aluminum; and other vitamins or herbal products.
- tell your doctor if you have or have ever had abnormalities of your esophagus; an overactive parathyroid gland; upper gastrointestinal disease such as ulcers, gastritis, heartburn, chronic stomach problems, or duodenitis; kidney disease; a history of neuroleptic malignant syndrome (high temperature with rigid muscles and abnormal consciousness); below-normal calcium levels in your blood; or low levels of vitamin D.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking tiludronate, call your doctor immediately.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking tiludronate.

# What special dietary instructions should I follow
It is important that you get enough calcium and vitamin D while you are taking tiludronate. Your doctor may prescribe supplements if your dietary intake is not enough.
Remember that tiludronate should be taken on an empty stomach, at least 2 hours after eating or taking medications. It should be taken with at least 6-8 ounces of water. Food, drinks, and other drugs (including vitamins, calcium, and vitamin D) should not be taken for at least 2 hours after taking tiludronate.

# What should I do if I forget a dose
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

# Side Effects

## Minor Side Effects
Tiludronate may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- upset stomach
- diarrhea
- stomach irritation or pain
- gas
- constipation
- vomiting
- decreased appetite
- swelling of the feet or legs
- headache
- dizziness
- nasal congestion
- muscle, joint, or bone pain
- red or irritated eyes
- throat pain
- difficulty sleeping
- tingling in extremities
- nervousness
- muscle contractions

## Severe Side Effects
If you experience any of the following symptoms, call your doctor immediately:
- rash
- blurred or decreased vision
- chest pain
- difficulty swallowing
- coughing
- fever
- sinus or respiratory infection
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online  or by phone .

# What storage conditions are needed for this medicine
Keep this medication in the container it came in, tightly closed, and out of reach of children. Do not remove tablets from foil strip until you are ready to take them. Store this medication at room temperature and away from excess heat and moisture (not in the bathroom). Talk to your pharmacist about the proper disposal of your medication.

# In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

# What other information should I know
Keep all appointments with your doctor and the laboratory. Your doctor may order certain laboratory tests to check your response to tiludronate.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

# Brand names
- Skelid