ibandronate
Ibandronate (Boniva) is used to treat and prevent osteoporosis (bone loss or weakening). It can help improve bone mineral density (BMD) and lower the risk of back fractures. Unlike other similar osteoporosis medications, ibandronate (Boniva) is only approved for women who have gone through menopause.
What is Ibandronate (Boniva)?
What is Ibandronate (Boniva) used for?
- Osteoporosis in women who have gone through menopause (postmenopause)
How Ibandronate (Boniva) works
Ibandronate (Boniva) is a bisphosphonate. Bisphosphonates work to slow down bone breakdown so the body can make new, healthy, and strong bone. Ibandronate (Boniva) helps raise BMD, which is a measure of how dense your bones are. A higher BMD means your bones are stronger, which helps lower your risk of bone fractures.
Drug facts
Side effects of Ibandronate (Boniva)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Stomach pain (8%)
- Heartburn (6%)
- Joint pain (6%)
- Back pain (5%)
- Nausea (5%)
- Diarrhea (5%)
- Arm or leg pain (4%)
- Headache (3%)
- Muscle pain (2%)
Less Common Side Effects
- Constipation
- Flu-like symptoms
- Common cold
- Urinary tract infection (UTI)
- Dizziness
- Trouble sleeping
Ibandronate (Boniva) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- New fractures: dull or aching pain in your hips or thigh, severe pain in your bones or joints
The following Ibandronate (Boniva) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Bladder pain
bloody or cloudy urine
cough producing mucus
difficult, burning, or painful urination
difficulty with breathing
fever or chills
frequent urge to urinate
lower back or side pain
nervousness
pounding in the ears
shortness of breath
slow or fast heartbeat
tightness in the chest
Less common
Bloody or cloudy urine
body aches or pain
congestion
difficulty with swallowing
dizziness
dryness of the throat
fast heartbeat
frequent urge to urinate
hoarseness
numbness
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
skin rash
tender, swollen glands in the neck
tingling
unusual tiredness or weakness
voice changes
Incidence not known
Abdominal or stomach cramps
blurred vision or other change in vision
bone, joint, or muscle pain, severe and occasionally incapacitating
confusion
convulsions
eye redness
eye tenderness
heavy jaw feeling
irregular heartbeats
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
loosening of a tooth
muscle cramps in the hands, arms, feet, legs, or face
noisy breathing
numbness and tingling around the mouth, fingertips, or feet
pain, swelling, or numbness in the mouth or jaw
sensitivity to light
severe eye pain
tearing
unusual pain in the thighs, groin, or hips
Get emergency help immediately if any of the following symptoms of overdose occur:
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
difficulty having a bowel movement (stool)
difficulty with moving
discouragement
feeling of constant movement of self or surroundings
feeling sad or empty
general feeling of discomfort or illness
irritability
joint pain
lack or loss of strength
lightheadedness
loss of interest or pleasure
muscle aches and pain
muscle stiffness
pain, swelling, or redness in the joints
sensation of spinning
shivering
sweating
tooth disorder
trouble concentrating
trouble sleeping
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Ibandronate (Boniva)
Pros
- Taken once a month as a tablet
- Also available as an IV infusion given by a healthcare provider every 3 months if there are too many stomach problems from the tablet
- Helps lower the risk of back fractures
- Available as a lower-cost generic medication
Cons
- Risk of many side effects, including stomach pain and severe jaw problems
- Not approved for osteoporosis caused by long-term corticosteroid use, men with osteoporosis, or people with Paget's disease
- Not recommended for people with severe kidney disease
Pharmacist tips for Ibandronate (Boniva)
- Mark the same date every month on your calendar to help you remember when to take ibandronate (Boniva).
- Take the whole tablet first thing in the morning with a full glass of plain water (6 oz to 8 oz) while standing or sitting upright. Don't chew or suck on the tablet. This can help lower your risk of irritating or causing ulcers in your esophagus (the tube that connects your throat to your stomach).
- Don't eat, drink anything (except plain water), or lie down for at least 1 hour after taking ibandronate (Boniva).
- Don't take other medications or supplements (like calcium, antacids, or vitamins) for at least 1 hour after taking ibandronate (Boniva). Some medications can block ibandronate (Boniva) from working as well in the body.
- It's important to have good mouth care when taking this medication to lower the risk of jaw problems. Let your dentist know you're taking ibandronate (Boniva) before starting the medication.
- You can take calcium and vitamin D supplements every day to prevent low calcium levels and help your bones grow stronger.
- If you have trouble swallowing, pain when you swallow, chest or stomach pain, new or worsening heartburn, or any pain around your hips, thighs, or jaw, tell your healthcare provider right away.
Common questions about Ibandronate (Boniva)
If you forget to take ibandronate (Boniva) on your chosen date of the month and your next scheduled dose is more than 7 days away, take it in the morning on the next day. If your next scheduled dose is 1 to 7 days away, wait until your next scheduled dose to take the medication. For the doses in the future, take ibandronate (Boniva) on your regular chosen date each month.
Take ibandronate (Boniva) before you eat or drink anything in the morning with a full glass of plain water (not mineral water). Mineral water can contain more calcium than plain water, which can block the medication from working as well in the body. To prevent stomach irritation, heartburn, or ulcers, it's important that you don't lie down for at least 1 hour after taking the tablet. Also, don't eat, drink, or take other medications (like vitamins, supplements, or antacids) for at least 1 hour after taking the medication.
If you're taking the tablet form of ibandronate (Boniva), you should take the medication once a month on the same date. Mark the date you need to take the medication each month on your calendar to help you remember when to take it. If you're getting the IV infusion, you will get it once every 3 months from your healthcare provider's office.
Ibandronate (Boniva) typically doesn't cause weight gain. Weight gain is common in postmenopausal women because of hormonal changes in the body, among other factors. Because ibandronate (Boniva) is used in women who have gone through menopause, weight gain might be related to this stage in life.
The American Association of Clinical Endocrinology guidelines recommend alendronate (Fosamax) as a first-choice option for postmenopausal women with osteoporosis rather than ibandronate (Boniva). This is because alendronate (Fosamax) works well to lower the risk of fractures in many parts of the body, including the hip and back, while ibandronate (Boniva) only works well to lower risk of back fractures. Ibandronate (Boniva) is also not FDA-approved for as many types of osteoporosis as alendronate (Fosamax) is.
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Risks and warnings for Ibandronate (Boniva)
Ibandronate (Boniva) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Stomach and esophagus irritation and ulcers
- Risk factors: History of ulcers or other digestive problems | Taking with aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) | Not drinking enough water when taking ibandronate (Boniva) | Lying down after taking ibandronate (Boniva)
Stomach and esophagus irritation, including heartburn, pain, and ulcers, can happen after taking ibandronate (Boniva). To help prevent irritation, it's very important to follow the directions on how to take the medication and any other directions your provider has given you. Take ibandronate (Boniva) with a full glass of plain water while standing or sitting upright, and avoid lying down for at least 1 hour. Stop taking ibandronate (Boniva) right away and talk to a healthcare provider if you notice you have trouble swallowing, new pain with swallowing, pain around the middle of your chest, or new or worsening heartburn while taking this medication.
Breakdown of the jawbone (osteonecrosis)
- Risk factors: Gum or dental disease or surgery | Anemia (low red blood cell count) | Bleeding problems | Cancer | Taking cancer medications at the same time | Poor mouth care or dentures that don't fit well | Taking ibandronate (Boniva) for a long time
Although rare, ibandronate (Boniva) can break down and weaken the jawbone. This breakdown is more likely if you get a tooth extraction, dental implants, bone surgery around or in your mouth, or an infection in the mouth that hasn't healed while taking ibandronate (Boniva). Keeping your teeth healthy with regular brushing and flossing can lower your risk of this problem. If you notice pain or swelling in your jaw, talk to your doctor or dentist right away. It's also important to let your dentist know that you're taking ibandronate (Boniva). You might need to complete any necessary dental work before starting the medication.
Severe bone, joint, or muscle pain
Though rare, some people taking ibandronate (Boniva) have had severe pain in their bones, joint, or muscles. It can happen as quickly as one day to several months after starting this medication. Generally, the pain improves after stopping the medication. If you feel severe pain in these areas, talk to a healthcare provider, as you might need to stop ibandronate (Boniva).
Leg bone fractures
- Risk factors: Taking corticosteroid medications at the same time
Very rarely, leg bone fractures can happen without any known cause in people taking ibandronate (Boniva). If you notice new dull or aching pain in your hips or thighs, tell your healthcare provider right away. You might need to stop taking ibandronate (Boniva).
Low calcium in the blood
- Risk factors: History of low calcium in the blood
Ibandronate (Boniva) can lower the calcium levels in your blood. If you have low calcium levels, you'll need to be treated before starting ibandronate (Boniva) to prevent this problem from getting worse. To help keep your calcium levels from getting too low, you might need to take calcium and vitamin D supplements. Talk to your healthcare provider if you notice muscle spasms or twitching, or numbness and tingling in your fingers, toes, or around your mouth, as these can be signs of low calcium levels.
Ibandronate (Boniva) dosage
Dose pack| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 1 tablet of 150mg | 1 dose pack | $12.49 | $12.49 |
| 3 tablets of 150mg | 1 dose pack | $19.66 | $19.66 |
Typical dosage for Ibandronate (Boniva)
The typical dose is 150 mg taken by mouth once a month. Take the tablet on the same day each month.
Ibandronate (Boniva) is also available as an intravenous (IV) infusion that's administered by a healthcare provider once every 3 months for the treatment of postmenopausal osteoporosis.
Interactions between Ibandronate (Boniva) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.
How much does Ibandronate (Boniva) cost?
Ibandronate (Boniva) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Ibandronate (Boniva) will not be safe for you to take.
- Issues affecting your esophagus
- Unable to stand or sit upright for at least 1 hour after taking the medication
- Low calcium levels in your blood
What are alternatives to Ibandronate (Boniva)?
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