A patient on ibandronic acid should be told to report any sign of which symptom?

• A. Ear discharge
• B. Skin rash
• C. Headache
• D. Nausea

Answer: (A)

Ibandronate is a bisphosphonate used to strengthen bone, but it can be associated with rare but serious adverse effects such as osteonecrosis of bone structures in the head and neck, including the jaw and, though less commonly reported, the external ear canal. Ear discharge can be a sign of osteonecrosis or an associated infection in the ear canal, which needs prompt medical evaluation. Because early recognition and management are important to prevent complications, patients are advised to report any ear discharge right away.

The other symptoms listed (rash, headache, nausea) can occur with many drugs and are less specific signals of a serious, potentially treatment-laltering complication.