Tiludronate (Oral)

As a bisphosphonate, tiludronate keeps the patient's bones strong by increasing bone density and preventing bone breakdown.


Tiludronate is used for treating Paget's disease, which is a condition that makes the bones soft, weak, painful and easily deformed or broken. It works by slowing down bone breakdown and increasing the density of bones, making them stronger and less likely to break. Tiludronate also reduces the bone pain that comes with this condition. It belongs to a class of medications known as bisphosphonates.

Conditions treated

  • Paget's disease

Type of medicine

  • Bisphosphonate

Side effects

Along with the desired effects, a drug may also cause certain unwanted effects. Not all of these effects are likely to occur, though, and if they do, get medical attention as soon as you can.

More common:

  • Fever
  • Cough
  • Nasal congestion
  • Sneezing
  • Runny nose
  • Voice changes/hoarseness
  • Head congestion
  • Sore throat

Less common:

  • Chest pain
  • Poor or blurred vision
  • Blindness
  • Headache
  • Itching, dry or burning eyes
  • Eye pain
  • Swollen face, lower legs, or feet
  • Red, painful and swollen eye, or eyelids
  • Unexplained weight gain


  • Blistering, peeling, or loosening of the skin
  • Bladder pain
  • Bloody/cloudy urine
  • Painful or difficult urination
  • Headache
  • Dizziness or lightheadedness
  • Nervousness
  • Fainting
  • Frequent urination
  • Pounding sensation in the ears
  • Spinning sensation
  • Pain or swelling in the arms or legs without any injury
  • Itchy red skin lesions, typically with a purple center
  • Lower back or side pain
  • Fast or slow heartbeat
  • Ulcers, sore or white spots on the lips or in the mouth

Seek emergency medical help immediately if any of the following symptoms of overdosing occur:

  • Abdominal/stomach cramps
  • Convulsions
  • Tremor
  • Confusion
  • Breathing difficulties
  • Shortness of breath
  • Irregular heartbeats
  • Mental or mood changes
  • Muscle cramps in the face, hands, arms, feet, or legs
  • Numbness and tingling around, fingertips, feet or mouth

Sometimes, side effects that usually don't require medical attention may occur. These side effects may disappear in the course of treatment, as your body adjusts itself to the medicine. Your health care provider may offer tips on how to prevent or diminish some of these side effects. Check with your doctor if any of these side effects persist or are bothersome or if you need more information about them:

More common:

Less common:

  • Vomiting
  • Skin rash
  • Abdominal gas
  • hroat pain
  • Bone fractures
  • Itching, burning, numbness, or tingling feelings
  • Confusion
  • Difficulty with bowel movements
  • Dry skin
  • Dizziness
  • Increased thirst
  • Hair loss
  • Increased urination
  • Pain in the joints
  • Muscle pain
  • Muscle cramps or spasms
  • Loss of appetite
  • Irritated/red eyes
  • Difficulty thinking
  • Tooth disorder


  • Sleeplessness
  • Stomach pain
  • Unusual tiredness or weakness
  • Dry mouth
  • Lack of strength
  • Redness of face, neck, arms and on occasion, upper chest
  • Unusual drowsiness or sleepiness
  • Nervousness or fear
  • Feeling of warmth

It is also possible to experience other side effects not mentioned above. Be sure to consult your doctor as soon as possible if you experience any other side effects.


Tiludronate is available in tablet form to take by mouth. The medication is typically taken once a day, on an empty stomach, for three months. Take this medicine at about the same time every day. If the symptoms return or get worse after some time has lapsed, this treatment may have to be repeated.

How to take tiludronate:

Tiludronate is effective at controlling Paget's disease only if it's taken as prescribed by your doctor. Do not stop using it without talking to your doctor. Do not take more or less of this medication, or take it for a longer period than your doctor instructed. Doing so may increase the chances of undesirable effects.

The tablet should be swallowed whole with a large glass of plain water (8 ounces, or 240ml). Do not substitute plain water with mineral water, coffee, juice, milk, or any other liquid. Remember that this medicine is best taken on an empty stomach, 2 hours before or after a meal. After taking the medicine, do not lie down for at least half an hour.

While using this medicine, it is vital that you eat a balanced diet, with sufficient amounts of calcium and vitamin D. Your healthcare professional should help you choose the best dietary plan for your condition.

If you also take calcium or other mineral supplements, or aspirin or indomethacin, take them 2 hours before or after taking tiludronate. If using antacids, wait a minimum of two hours after taking tiludronate before taking the antacid. Taking these medications and mineral supplements together with tiludronate may reduce its efficacy.

Tiludronate typically takes 3 months to work. Talk to your physician if you feel that the medication is not working. Do not, however, stop taking the medication without consulting your doctor.

Missed dose:

In case of a missed dose, make sure you take it as soon as you remember. You may however return to the regular dosing schedule if it's almost time for your next dose. Do not compensate for a missed dose by double dosing.


Contact your local poison control center as soon as an overdose is suspected. For US residents, the national poison hotline is 1-800-222-1222.

Drug Interactions

Drug interactions may affect the effectiveness of your medicine, or heighten the risk for severe side effects. This medication guide does not cover all possible drug interactions. It is important that you keep a list of all the products you're using, including prescription and nonprescription drugs, as well as herbal products and dietary supplements. Share this list with your pharmacist or doctor at every visit. Do not stop taking tiludronate or change the dose without your healthcare professional's approval.

Medical problems:

Other medical conditions the patient may have could affect the use of this medicine. Be sure to inform your doctor if you suffer from or have a history of any other medical conditions, especially:

  • Anemia
  • Severe muscle pain
  • Dental/tooth problems
  • Blood clotting problems
  • Cancer, or use of medication for cancer
  • Infection
  • Bone or joint pain
  • Barrett's esophagus
  • Esophagus problems, such as difficulty swallowing or inflammation

Poor oral hygiene - medication should be used with caution; may heighten risk of a serious side effect on the jaw.

Stomach and bowel problems such as gastritis, ulcers or heartburn - use tiludronate with caution as it may aggravate these conditions.

Kidney disease - must be used with caution; effects may be increased due to slower elimination of the medication from the body.

While taking tiludronate, do not drink alcohol, or use tobacco products as these may cause some interactions and make side effects worse.


This medication is known to cause drowsiness, and the effect may worsen if you use it with alcohol or certain medications. Use it with caution, and avoid driving or performing other tasks that may put you at risk until you know how your body responds to it.

Let your doctor know if you are allergic to tiludronate, any other drugs, or any of the ingredients present in the drug. You can obtain the list of ingredients in tiludronate from your pharmacist.

Do not take tiludronate for longer than the prescribed time, or more than the recommended dosages. Follow the doctor's prescription and also read the instructions on the prescription label.

Let your doctor know if you are not able to sit or stand upright for at least 30 minutes after taking tiludronate. If this is the case, your doctor will probably advise against taking the medication.

Be aware that tiludronate can cause severe muscle, joint and bone pain. This pain may come within days, months or even years after first taking the medicine. Though this type of pain may begin after taking tiludronate for some time, it's important that you and your doctor identify tiludronate as the cause of the pain. At any time during the course of treatment with tiludronate, contact your doctor immediately if you experience serious pain. Your doctor may instruct you to stop taking the medication, and the pain may ease off after you stop.

Having enough vitamin D and calcium is important while taking this medicine. Talk to your pharmacist or doctor about your diet and any dietary supplements you may need, such as vitamin D and calcium.

This medication has been reported to cause jawbone problems in some patients. The risk increases with prolonged use, or if you have poor dental hygiene, cancer, or certain other health conditions, including: dental problems, infections, blood clotting problems, or anemia. The risk is also greater with the use of certain medications or therapies, such as radiation, chemotherapy, and corticosteroids. Ask your doctor about dental examination before you start using tiludronate.

Before receiving dental care, surgery, or any other kind of medical care, tell your dentist or doctor that you use tiludronate.

Some patients with asthma have reported worsening of their condition while taking medications like this one. If you are asthmatic, discuss this concern with your doctor.

Your doctor may order lab tests to check things such as your calcium levels while using tiludronate. Such tests are necessary for monitoring your condition, as well as checking for side effects. Make sure you keep all your appointments with your doctor and the lab.

The use of tiludronate in children should be done with extreme caution. There are adequate studies yet to show the effectiveness and safety of this drug in children.

The FDA classifies tiludronate as a pregnancy category C medicine. This means use of the drug during pregnancy has not been sufficiently evaluated and it is therefore not known if it can cause harm to the fetus. Tell your doctor if you are pregnant or become pregnant while taking this medication - you will need to consider the benefits and risks of taking it while pregnant. It has not been established yet if this medicine passes into breast milk. Discuss with your doctor about using tiludronate while breastfeeding.


Keep this medication in its original container, tightly sealed, and in a place children cannot reach. Store the medication at room temperature, away from too much heat or moisture. Do not keep it in the bathroom.

Dispose of unneeded medication properly to ensure other people or children cannot find and consume it. It is however not advisable to flush the medication down the toilet. A better way would be to dispose of it through a take-back program. To find out about the take-back programs in your community, ask your pharmacist or local garbage recycling department.


Tiludronate is prescribed to patients with Paget's disease, a condition characterized by soft, weak and painful bones that may deform or break easily. Tiludronate is a bisphosphonate drug which works to prevent the breakdown of bones and alleviate bone pain. With proper use, this medication helps with increasing bone density, making the patient's bones stronger and less easy to break.

As with other medications, it is important to follow the doctor's instructions while taking tiludronate. The medication is usually prescribed for 3 months, and should be taken on an empty stomach once a day, at around the same time each day. It is also important that you eat a properly balanced diet with enough calcium and vitamin D. Your doctor or pharmacist may advise you on the use of calcium and vitamin supplements.

Use of this medication may cause severe pain in the bones, joints and muscles. Tell your doctor immediately if you start experiencing such pain. Your doctor may have to take you off the drug, and your pain will go away when you stop taking the medicine. Additionally, get emergency medical help for any serious side effects, such as abdominal/stomach cramps, convulsions, tremor, confusion, breathing difficulties, shortness of breath, or irregular heartbeat.

Remember to keep all your doctor and lab test appointments so the doctor can keep track of your progress and also check for side effects. Also make sure you keep a list of all drugs you are currently using, including prescription and nonprescription drugs, plus any herbs or supplements you use or want to start using, and always show this list to your healthcare professional at every appointment.

Last Reviewed:
December 23, 2017
Last Updated:
April 05, 2018
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