How to Take Boniva: 5 Pharmacist-Backed Tips for Taking Oral Ibandronate

If you’ve gone through menopause, you may be at an increased risk of osteoporosis. Bisphosphonates are a group of medications commonly prescribed to lower this risk and treat osteoporosis if it develops. Of these, Boniva (ibandronate) is one option that comes as both an oral tablet and intravenous (IV) injection.

What sets oral Boniva apart is its once-monthly dosage, which offers convenience compared to daily or weekly alternatives. But like other bisphosphonates, there are specific guidelines to follow when taking it. Here’s how to take Boniva, plus four other pharmacist-backed tips for taking oral ibandronate.

1. Take Boniva in the morning at least 60 minutes before eating or drinking

To maximize Boniva’s absorption, take your dose first thing in the morning on an empty stomach. Then, wait for at least 60 minutes before you eat or drink anything else. You’ll also need to wait at least 60 minutes before taking any other medications or supplements.

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• Take without food: Boniva should be taken before at the start of your day before eating or drinking. Learn about why some medications should be taken on an empty stomach.

Why does timing matter? If you take Boniva with food, beverages (other than plain water), or other medications, they can interfere with how your body absorbs your dose. Without proper absorption, Boniva won’t work as intended.

2. Swallow Boniva whole with a full glass of water

When taking Boniva, swallow the tablet whole with 6 oz to 8 oz of plain water. Avoid other morning drinks, such as coffee, tea, or juice, since they can interfere with absorption.

Do not chew, crush, or break Boniva tablets. And don’t let them dissolve in your mouth, either. Doing so can irritate or damage the lining of your esophagus. If you have difficulty swallowing the pills, talk to your prescriber about switching to the IV injection as an alternative.

3. Remain upright for at least 60 minutes after taking Boniva

After taking Boniva, remain in an upright position (sitting or standing) for at least 60 minutes. This helps the tablet move smoothly down your esophagus and into your stomach, which can lower the risk of irritation or damage.

If you’re unable to sit or stand for a full 60 minutes after each Boniva dose, tell your prescriber. They may suggest the IV injection form instead.

4. Take Boniva on the same day each month

A unique feature of Boniva is that you only need to take it once a month. To stay on track, choose a consistent day of the month that works best for you. For example, you might choose the 1st or 15th. Once you choose, take Boniva on that day every month.

What happens if you miss your monthly Boniva dose? Here’s are the steps that can get you back on schedule:

• If your next dose is more than 7 days away, take the missed dose in the morning after you remember. Then, continue with your regular schedule.

• If your next dose is within 7 days, skip the missed dose and wait until your next scheduled day.

• Never double up doses to make up for a missed one.

It may be helpful to use a calendar or medication reminder app to help keep you on track with your monthly Boniva doses. And if you’re still having trouble remembering your dose, the IV injection could be a good alternative. It’s given once every 3 months in a medical setting.

5. Avoid taking calcium or iron supplements around the time you take Boniva

Many people with osteoporosis are advised to take a calcium supplement to support bone health. And you may be taking other vitamins and minerals, too. But supplements or other products (such as antacids) containing calcium, magnesium, and iron can bind to Boniva, reducing its absorption and effectiveness.

To avoid this interaction, take products containing calcium, magnesium, and iron at least 60 minutes after your Boniva dose.

How to save on Boniva

Brand-name Boniva has been discontinued. But it’s currently available as lower-cost generics. With a free GoodRx discount, the price of generic ibandronate tablets is as low as $25.00 for a 90-day (3-month) supply at certain pharmacies.

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Written by:

Brian Leonard, PharmD, BCACP, BCGP

Brian Leonard earned his doctorate in pharmacy from the University of Florida College of Pharmacy and is board certified in Ambulatory Care and Geriatric Pharmacy.

Edited by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

Reviewed by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

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