The most common grade 3 or 4 adverse events were fatigue ( 97 [ 14 % ] of 697 patients allocated zoledronic acid vs 98 [ 14 % ] of 704 allocated ibandronic acid ) , increased bone pain ( 91 [ corrected ] [ 13 % ] vs 85 [ corrected ] [ 12 % ] ) , joint pain ( 41 [ corrected ] [ 6 % ] vs 38 [ 5 % ] ) , infection ( 31 [ 5 % ] vs 23 [ corrected ] [ 3 % ] ) , and nausea or vomiting ( 38 [ 5 % ] vs 41 [ 6 % ] ) .