Medical Editor: Jay W. Marks, MD

GENERIC NAME: ibandronate

BRAND NAME: Boniva

DRUG CLASS AND MECHANISM: Ibandronate is an oral drug that is used for treating osteoporosis. It is in a class of drugs called bisphosphonate that includes alendronate (Fosamax) and risedronate (Actonel), both of which are orally available which can be taken daily or weekly. Ibandronate may be taken daily, but it is the only oral biphosphonate that is approved to be taken monthly. There are also several injectable bisphosphonate, etidronate (Didronel), pamidronate (Aredia)] and zoledronate (Zometa), which can also be used to prevent or treat osteoporosis and which may be given every three months or yearly. All of the bisphosphonates prevent the breakdown of bone by bone cells called osteoclasts. In persons who are at high risk for osteoporosis, bisphosphonates not only result in increased amounts of bone and bone strength, they also reduce the risk of hip fractures and other bone fractures.

GENERIC AVAILABLE: No

PRESCRIPTION: Yes

PREPARATIONS: Tablets, 2.5 and 150 mg; Intravenous injection, 3 mg/3 ml

STORAGE: Ibandronate tablets should be stored at room temperature, 15-30°C (59-86°F). Keep all medicines away from the reach of children.

PRESCRIBED FOR: Ibandronate is used to prevent and to treat osteoporosis in women after the menopause.

DOSING: The dose of ibandronate is 2.5 mg once daily or 150 mg once monthly. If monthly dosing is used, the tablet should be taken on the same day of each month. Tablets should be taken at least 60 minutes before the first food or drink of the day (other than plain water) or before other oral medication, because of concern that that food or medication will interfere with the absorption of ibandronate. (Absorption of ibandronate from the intestine is poor, and any potential further decrease in absorption by food or medications needs to be avoided.) Ibandronate tablets also should be swallowed whole with six to eight ounces of plain water while in an upright position, in order to be certain that the tablets enter the stomach. (If the tablets stick in the esophagus they can irritate the esophagus.) For the same reason, one should not lie down for 60 minutes after taking ibandronate. (Tablets are more likely to stick in the esophagus when lying down.) Tablets should not be chewed or sucked in order to avoid irritation of the mouth and throat.

The dose of ibandronate intravenously is 3 mg every three months. 

DRUG INTERACTIONS: Other than the potential for interference with absorption (most notable with some foods, calcium and iron), there are no known drug interactions with ibandronate.

PREGNANCY: Bisphosphonates have been shown to cause fetal harm in animals, but there are no data on risk to the fetus in humans. Ibandronate should be used during pregnancy only if the physician feels that its potential benefit justifies the potential risk to the fetus.

NURSING MOTHERS: Ibandronate appears in the breast milk of animals. It is not known whether it appears in human breast milk. Since most medications do appear in human breast milk, it is generally recommended that caution be exercised when ibandronate is given to lactating women.

SIDE EFFECTS: Ibandronate is generally safe, with the overall rate of reported side effects being the same as with placebo (a look alike, but inactive tablet). Some of the more common side effects reported include back pain, pain in the arms or legs, abdominal pain, and diarrhea.

From the Doctors at MedicineNet.com

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