Omudhome Ogbru, PharmD
Omudhome Ogbru, PharmD
Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Medical and Pharmacy Editor:
GENERIC NAME: ibandronate
BRAND NAME: Boniva
DRUG CLASS AND MECHANISM: Ibandronate is an oral and intravenous drug that is used for treating osteoporosis. It is a member of the bisphosphonate class of drugs which includes etidronate (Didronel), pamidronate (Aredia), risedronate (Actonel), and tiludronate (Skelid). Bone is in a constant state of remodeling. New bone is laid down by cells called osteoblasts while old bone is removed by cells called osteoclasts. Bisphosphonates strengthen bone by inhibiting bone removal (resorption) by osteoclasts. After menopause, there is an increased rate of bone loss leading to osteoporosis, and ibandronate has been shown to increase bone density and decrease fractures of bones. FDA approved ibandronate in May 2003.
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 150 mg; Intravenous injection, 3 mg/3 ml
STORAGE: Ibandronate tablets should be stored at room temperature, 15-30 C (59-86 F).
PRESCRIBED FOR: Ibandronate is used to prevent and treat osteoporosis in women after menopause. The optimum duration of treatment has not been established and treatment should be evaluated periodically.
DOSING: The dose of ibandronate is 150 mg orally once monthly. 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, patients should not lie down for 60 minutes after taking ibandronate since 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 administered intravenously is 3 mg administered over 15-30 seconds every three months.
DRUG INTERACTIONS: Calcium supplements, antacids, and other products that contain aluminum, magnesium, or iron may reduce absorption of ibandronate. Ibandronate should be administered at least 60 minutes before administration of any oral medication, including medications containing iron, aluminum, magnesium, or calcium.
Patients should wait at least 60 minutes after taking ibandronate before taking other oral medications. The occurrence of irritation in the stomach and intestines may increase if aspirin and other nonsteroidal anti-inflammatory drugs (for example, Motrin, Aleve) are combined 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 is secreted into the breast milk of animals. It is not known whether it is secreted into 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 women who are nursing.
SIDE EFFECTS: Some of the more common side effects of ibandronate include headache, back pain, pain in the legs or arms, abdominal pain, nausea, stomach upset, diarrhea, and high blood pressure. Low calcium levels may occur if calcium and vitamin D intake is not adequate. Severe irritation of the esophagus (for example, esophagitis, esophageal ulcers, esophageal erosions) can occur. This occurs more often when patients do not drink enough water with ibandronate, wait less than 60 minutes before lying down after taking ibandronate, or continue to take ibandronate after developing symptoms of esophageal irritation. Ibandronate should not be used by individuals with abnormalities of the esophagus.
Patients may experience jaw problems (osteonecrosis of the jaw) associated with delayed healing and infection after tooth extraction. Bone, joint, and muscle pain also occur and low-trauma femoral fractures have been reported.
Reference: FDA Prescribing Information
Last Editorial Review: 2/14/2012
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