Binosto Warnings and Precautions

Specific Precautions and Warnings for Binosto

Some warnings and precautions to be aware of prior to taking this medicine include the following:
  • Binosto can be irritating to the stomach and esophagus, which could cause inflammation, ulcers, and bleeding. It is very important to remain upright for at least 30 minutes after taking your dose to help reduce the chance that the drug will irritate your esophagus. Let your healthcare provider know if you develop chest pain, new or worsening heartburn, or have pain or difficulty when swallowing during treatment.
  • Binosto may lower blood calcium levels (known medically as hypocalcemia). Your healthcare provider will make sure your calcium levels are normal with a blood test before starting treatment. It is also important to get enough calcium and vitamin D during treatment, either through food or supplements. Your healthcare provider or pharmacist can tell you how much calcium and vitamin D you need to consume each day.
  • Bisphosphonate medications such as Binosto have been reported to cause severe bone, joint, and muscle pain. These symptoms have been reported anywhere from one day to several months after starting the medication. Let your healthcare provider know if you develop any bone, joint, or muscle pain during treatment.
  • Although rare, bisphosphonates such as Binosto have been associated with a serious condition in which the bone of the jaw begins to weaken and die (known as osteonecrosis of the jaw). This usually causes pain and other symptoms, such as infections or loosening of the teeth, but in some cases, symptoms do not occur until the jaw bone becomes exposed. The problem is more likely to occur when bisphosphonates are given as an injection into a vein (an IV injection), but can also happen when they are taken by mouth.

    Certain things appear to increase the risk for developing osteonecrosis of the jaw, including cancer treatment, invasive dental procedures, the use of steroid medications, and certain medical problems such as infections and anemia. Good oral hygiene and dental care may help reduce the risk, so take good care of your mouth and see your dentist regularly during treatment. Make sure your dentist knows you are taking Binosto. Also, let your healthcare provider know right away if you have symptoms of osteonecrosis of the jaw.  
  • Bisphosphonates, including Binosto, may increase the risk for a rare type of broken bone known as an atypical femoral (thigh bone) fracture. This unusual type of fracture occurs with little or no trauma to the bone. Some people describe dull, aching pain in the area for weeks or months before the fracture occurs. It is not entirely clear that bisphosphonates actually cause the fractures -- they could be due to osteoporosis itself or other factors. Let your healthcare provider know right away if you develop hip, thigh, or groin pain while taking this medicine.
  • Binosto is generally not recommended for use in people with severe kidney disease.
  • People who have been told to follow a low-salt diet should know that Binosto contains 650 mg of sodium, which is about equal to 1650 mg of table salt (sodium chloride). 
  • Binosto is a pregnancy Category C medication. This means that it may not be safe for use during pregnancy, although the full risks are currently unknown (see Binosto and Pregnancy).
  • It is unknown if Binosto passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Binosto and Breastfeeding).
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