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Why is this medication prescribed?

Tiludronate is a bisphosphonate medication primarily prescribed for the treatment of Paget’s disease of bone, a condition characterized by abnormal bone remodeling, leading to weakened and deformed bones. It works by inhibiting the breakdown of bone, thus helping to reduce bone pain, prevent fractures, and improve bone density.

How should this medicine be used?

Here’s how Tiludronate is typically prescribed and used:

  • Dosage: The dosage of Tiludronate can vary depending on the specific condition being treated, the severity of the condition, and other factors such as the patient’s age and overall health. It’s essential to follow the dosage instructions provided by the prescribing healthcare professional.
  • Administration: Tiludronate is usually taken orally, in the form of tablets. It’s essential to swallow the tablet whole with a full glass of plain water (not mineral water) on an empty stomach. Typically, patients are instructed to take Tiludronate at least 30 minutes before food, drink (other than water), or other medications.
  • Timing: After taking Tiludronate, patients are advised to remain upright (sitting or standing) for at least 30 minutes to minimize the risk of esophageal irritation or ulceration.
  • Frequency: The frequency of Tiludronate dosing can vary. It’s typically taken either daily or weekly, as prescribed by the healthcare provider.
  • Duration: Treatment duration with Tiludronate is determined by the underlying condition being treated and the patient’s response to the medication. It’s essential to continue taking Tiludronate as prescribed, even if symptoms improve, unless otherwise directed by a healthcare professional.
  • Follow-up: Regular follow-up appointments with the prescribing healthcare provider are essential to monitor the effectiveness of the treatment and assess for any potential side effects or complications.

It’s crucial to adhere to the prescribed dosage and administration instructions strictly. Additionally, patients should not take Tiludronate if they have certain medical conditions or if they are allergic to bisphosphonates. As with any medication, it’s essential to discuss any questions or concerns with a healthcare provider before starting Tiludronate therapy.

Other uses for this medicine

Some potential off-label uses of tiludronate may include:

  • Treatment of bone metastases: Bisphosphonates like tiludronate may be used to manage bone pain and reduce the risk of fractures associated with bone metastases in certain types of cancer, such as breast cancer and prostate cancer.
  • Hypercalcemia of malignancy: Tiludronate may be used in the treatment of hypercalcemia (elevated levels of calcium in the blood) that is associated with certain types of cancer.
  • Reflex sympathetic dystrophy: There is some limited evidence suggesting that bisphosphonates like tiludronate may be beneficial in the treatment of reflex sympathetic dystrophy, a chronic pain condition characterized by severe pain, swelling, and changes in skin color.

What special precautions should I follow?

Special precautions should be followed when taking tiludronate to ensure its safe and effective use. Some of these precautions include:

  • Kidney function: Tiludronate is primarily excreted through the kidneys. Therefore, it is essential to monitor kidney function regularly, especially in patients with pre-existing kidney disease. Dosage adjustments may be necessary in patients with impaired renal function.
  • Dental health: Bisphosphonates, including tiludronate, have been associated with a rare but severe side effect called osteonecrosis of the jaw (ONJ), which is characterized by the death of bone tissue in the jaw. Patients taking bisphosphonates should maintain good oral hygiene and undergo regular dental check-ups. Dental procedures that involve invasive dental work should be avoided if possible during bisphosphonate treatment.
  • Esophageal irritation: Tiludronate tablets should be taken with a full glass of plain water (not mineral water) and swallowed whole while in an upright position to reduce the risk of esophageal irritation or ulceration.
  • Pregnancy and breastfeeding: The safety of tiludronate during pregnancy and breastfeeding has not been established. Women who are pregnant, planning to become pregnant, or breastfeeding should consult their healthcare provider before taking tiludronate.
  • Other medications: Tiludronate may interact with other medications, including certain antibiotics, antacids, and nonsteroidal anti-inflammatory drugs (NSAIDs). Patients should inform their healthcare provider about all medications they are taking, including prescription, over-the-counter, and herbal supplements, to avoid potential drug interactions.

As always, it’s crucial to discuss any questions or concerns about tiludronate or its use with a healthcare provider.

What special dietary instructions should I follow?

Regarding special dietary instructions for Tiludronate, there are no specific dietary restrictions associated with its use. However, it’s essential to maintain a balanced diet rich in calcium and vitamin D to support bone health.

What should I do if I forget a dose?

If you forget to take a dose of Tiludronate, take it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you have any concerns or questions about missed doses, consult your healthcare provider or pharmacist for guidance.

What side effects can this medication cause?

Tiludronate, like any medication, can cause side effects. Not everyone will experience these side effects, and their severity can vary from person to person. Common side effects of Tiludronate may include:

  • Gastrointestinal discomfort: This may include symptoms such as stomach pain, indigestion, nausea, vomiting, diarrhea, or constipation.
  • Musculoskeletal pain: Some individuals may experience bone, joint, or muscle pain while taking Tiludronate.
  • Headache: Headaches are a common side effect reported by some individuals taking Tiludronate.
  • Flu-like symptoms: Some people may experience symptoms resembling the flu, such as fever, chills, or fatigue.
  • Esophageal irritation: Tiludronate tablets can sometimes cause irritation or inflammation of the esophagus, leading to symptoms such as difficulty swallowing, chest pain, or heartburn.
  • Osteonecrosis of the jaw (ONJ): This is a rare but severe side effect associated with bisphosphonates, including Tiludronate. ONJ is characterized by the death of bone tissue in the jaw and can lead to symptoms such as jaw pain, swelling, or infection.
  • Atypical fractures: Long-term use of bisphosphonates like Tiludronate has been associated with an increased risk of atypical fractures, particularly in the thigh bone (femur).
  • Hypocalcemia: In some cases, Tiludronate may lower blood calcium levels, leading to symptoms such as muscle cramps, numbness or tingling in the fingers or around the mouth, or seizures.

It’s essential to report any side effects experienced while taking Tiludronate to your healthcare provider. They can help determine whether the side effects are manageable or require further evaluation and may recommend adjustments to your treatment plan if necessary. Additionally, if you experience severe or concerning side effects, such as difficulty breathing, severe allergic reactions, or persistent jaw pain, seek immediate medical attention.

What should I know about storage and disposal of this medication?

Storage and disposal instructions for Tiludronate:


  • Keep Tiludronate tablets in their original container with the lid tightly closed, away from moisture, heat, and light.
  • Store Tiludronate at room temperature, typically between 20 to 25 degrees Celsius (68 to 77 degrees Fahrenheit).
  • Keep Tiludronate out of reach of children and pets, as accidental ingestion can be harmful.


  • Dispose of any unused or expired Tiludronate tablets properly.
  • Do not flush Tiludronate down the toilet or pour it down the drain unless instructed to do so by a healthcare professional or local waste disposal authority.
  • Follow any specific disposal instructions provided by your healthcare provider or pharmacist, such as using a drug take-back program or community disposal program.

In case of emergency/overdose

In case of emergency or overdose of Tiludronate, immediate medical attention is necessary. Symptoms of overdose may include severe gastrointestinal irritation, hypocalcemia (low blood calcium levels), and potential renal impairment. If you suspect an overdose or experience severe symptoms after taking Tiludronate, contact your local poison control center or emergency room for assistance.

What other information should I know?

  • Regular monitoring: Your healthcare provider may recommend regular monitoring of bone density, kidney function, and other parameters while taking Tiludronate to assess its effectiveness and detect any potential side effects or complications.
  • Lifestyle modifications: In addition to taking Tiludronate, lifestyle modifications such as regular weight-bearing exercise, smoking cessation, and adequate intake of calcium and vitamin D can help support bone health and maximize the effectiveness of treatment.
  • Follow-up appointments: Attend all scheduled follow-up appointments with your healthcare provider to discuss your progress, address any concerns or questions, and make any necessary adjustments to your treatment plan.
  • Medication interactions: Inform your healthcare provider about all medications you are taking, including prescription, over-the-counter, and herbal supplements, as Tiludronate may interact with certain medications.

By following these guidelines and staying informed about Tiludronate, you can help ensure its safe and effective use as part of your treatment plan.

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