What is ibandronate, and how does it work (mechanism of action)?
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.
What brand names are available for ibandronate?
Boniva
Is ibandronate available as a generic drug?
Yes
Do I need a prescription for ibandronate?
Yes
What are the uses for ibandronate?
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.
What are the side effects of ibandronate?
Some of the more common side effects of ibandronate include:
-
Pain in the legs or arms
- Stomach upset
- Tooth disorder
- Abnormal weakness
- Indigestion
- Dizziness
Other side effects include:
- Bone pain
- Joint pain
- Muscle pain
Possible serious side effects include:
- Respiratory tract infections
- Pneumonia
- Bronchitis
- Urinary tract infections (UTIs)
- Low-trauma femoral fractures
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.
QUESTION
What is another medical term for osteoporosis?
See Answer
What is the dosage for ibandronate?
- 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.
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Which drugs or supplements interact with ibandronate?
-
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 (NSAIDs), for example, ibuprofen (Motrin),
Advil, naproxen (Aleve) are combined with ibandronate.
Is ibandronate safe to take if I’m pregnant or breastfeeding?
- 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. - 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.
What else should I know about ibandronate?
What preparations of ibandronate are available?
- Tablets: 150 mg
- Intravenous injection: 3 mg/3 ml
How should I keep ibandronate stored?
Ibandronate tablets should be stored at room temperature,
15 C – 30 C (59 F – 86 F).