ibandronate, Boniva (cont.)

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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.



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