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Fosamax vs. Boniva

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Alendronate (Fosamax) and ibandronate (Boniva) are both bisphosphonates used to treat and prevent osteoporosis, but they have some key differences. Alendronate (Fosamax) can be used by both men and women, while ibandronate (Boniva) is only approved for postmenopausal women. Alendronate (Fosamax) offers more flexibility in dosing, with options for daily or weekly oral intake, and it also comes in different forms like tablets, oral solutions, and effervescent tablets. In contrast, ibandronate (Boniva) is taken once a month as a tablet or as an IV infusion every three months. Alendronate (Fosamax) is recommended as a first-choice option because it lowers the risk of fractures in various parts of the body, including the hip and back, whereas ibandronate (Boniva) mainly reduces the risk of back fractures. Both medications have similar side effects, such as stomach pain and severe jaw problems, but ibandronate (Boniva) has a slightly higher incidence of common side effects like heartburn and joint pain.

Alendronate

(Fosamax)

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Ibandronate

(Boniva)

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Summary for Fosamax

Prescription only

Alendronate sodium (Fosamax) is a bisphosphonate that prevents and treats osteoporosis. It works by slowing the breakdown of bones so that the body has a chance to build up more bone; this strengthens bones and lowers the risk of fractures. Alendronate (Fosamax) is taken by mouth, either daily or weekly dosing, depending on your dose. In addition to the tablet, it's also available as an oral solution and a dissolvable tablet (brand name Binosto). Some common side effects of alendronate (Fosamax) can include stomach pain, heartburn, and bone or muscle pain.

Indications for Fosamax

Pros and Cons for Fosamax

Pros

Cons

  • Can't lie down for 30 minutes after you take it
  • Must take on empty stomach, can't eat for 30 minutes after a dose
  • Can cause serious jaw problems and severe muscle or joint pain
  • Has many stomach-related side effects

Common Side Effects for Fosamax

  • Stomach pain (up to 7%)
  • Muscle, bone, and joint pain (up to 4%)
  • Heartburn or indigestion (up to 4%)
  • Nausea (up to 4%)
  • Passing gas (up to 4%, more common with daily dose)

Warnings for Fosamax

  • Irritation and ulcers of the stomach and esophagus
  • Lower calcium levels
  • Muscle Pain
  • Jaw bone problems
  • Leg bone fractures
  • Not recommended in people with serious kidney problems

Summary for Boniva

Prescription only

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.

Indications for Boniva

  • Osteoporosis in women who have gone through menopause (postmenopause)

Pros and Cons for 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

Common Side Effects for Boniva

  • 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%)

Warnings for Boniva

  • Stomach and esophagus irritation and ulcers
  • Breakdown of the jawbone (osteonecrosis)
  • Severe bone, joint, or muscle pain
  • Leg bone fractures
  • Low calcium in the blood

Prices with our coupons for Fosamax vs. Boniva

Price Card Drug Icon
Alendronate3 dose packs / 4 tablets of 70mg
$16.67$112.89
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Price Card Drug Icon
Ibandronate1 dose pack / 3 tablets of 150mg
$24.42$250.08
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