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Boniva (ibandronate): Osteoporosis Drug Uses & Side Effects

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?


Is ibandronate available as a generic drug?


Do I need a prescription for ibandronate?


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:

Other side effects include:

Possible serious side effects include:

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


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
  • 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
    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

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).


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