Uses
What is ibandronate used for?
Ibandronate is commonly used to treat or prevent osteoporosis after menopause. Osteoporosis is a condition where your bones become thin and weak and may break more easily.
Ibandronate may also be used for other conditions as determined by your healthcare provider.
How does ibandronate work (mechanism of action)?
Ibandronate slows the natural breakdown of your bones. This helps them stay stronger and reduces the risk for bone fractures.
How is ibandronate supplied (dosage forms)?
Ibandronate is available in the following dosage form that is taken by mouth.
- 150 mg oral tablets
Ibandronate is also available in injectable forms.
How should I store ibandronate?
Ibandronate should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place. Keep tightly closed.
Side Effects
What are the most common side effects of ibandronate?
The most common side effects of ibandronate are listed below. Tell your healthcare provider if you have any of these side effects that bother you.
- Back pain
- Joint or muscle pain (see below)
- Pain in your arms or legs
- Stomach pain, diarrhea, or indigestion
- Headache
- Flu-like symptoms
There may be other side effects of ibandronate that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.
What are the serious side effects of ibandronate?
While less common, the most serious side effects of ibandronate are described below, along with what to do if they happen.
Esophagus Problems. Taking ibandronate by mouth may irritate the esophagus or upper part of your gastrointestinal (GI) tract. This irritation can be worse in people who already have stomach or esophagus problems. In some cases, it can lead to problems such as ulcers, bleeding, or tears in the esophagus, which may require hospitalization. To reduce the risk of these problems, it is important to take an ibandronate tablet with a full glass of plain water and stay upright after taking it. Stop taking ibandronate and call your healthcare provider right away if you have any of the following symptoms.
- Trouble or pain while swallowing
- Chest pain
- New or worsening heartburn
Low Calcium Level (Hypocalcemia). Ibandronate can cause low calcium levels, also known as hypocalcemia, which can be serious. Decreased calcium levels can cause a rare dangerous heart rhythm problem called QT prolongation and torsade de pointes. Some people have a higher risk of this, including people who are older, have other people in their family who have had these conditions, have low potassium or magnesium, or who take some medicines for other heart rhythm problems. Call your healthcare provider if you have any of the following symptoms.
- Changes in your heart rate or rhythm, such as fast or skipping heartbeat
- Fainting
- Numbness, tingling, or burning sensation in your arms, feet, or face (paresthesia)
- Muscle pain, spasms, twitching, or cramps
- Seizures
Severe Pain in the Bones, Joints, or Muscles. Ibandronate may cause severe pain in the bones, joints, or muscles (musculoskeletal pain). The pain can be severe enough that it could be difficult to carry out normal activities. Call your healthcare provider if you experience severe pain while on ibandronate.
Severe Jawbone Problems (Osteonecrosis). Ibandronate can rarely cause severe jawbone problems, also called osteonecrosis of the jaw. In this condition, your jawbone may get damaged due to reduced blood flow. You may be at higher risk if you are undergoing certain dental procedures (such as a tooth extraction or dental implants), if you have poor oral health, or if you have cancer or certain other conditions. You may be told to see a dentist before starting ibandronate and to practice good mouth care. Call your healthcare provider right away if you experience any of the following symptoms of jaw osteonecrosis.
- Jaw pain or discomfort
- Mouth sores
- Loose teeth
Unusual Thigh Bone Fractures. Ibandronate may cause an increased risk for fractures in your thigh bone, even with a light force. Call your healthcare provider if you experience new or unusual pain in your thigh, hip, or groin.
Kidney Damage. Kidney damage can happen when using the injectable form of ibandronate. Call your healthcare provider right away if you have any of the following symptoms of kidney damage.
- Reduced need to pee
- Swelling in your feet, ankles, or legs (edema)
- Weakness or unusual tiredness
- Difficulty in catching your breath or chest pain/pressure
- Confusion
- Nausea
- Seizures
Severe Allergic Reactions. Ibandronate can cause allergic reactions, which can be serious. Stop taking ibandronate and get help right away if you have any of the following symptoms of a serious allergic reaction.
- Breathing problems or wheezing
- Racing heart
- Fever or general ill feeling
- Swollen lymph nodes
- Swelling of the face, lips, mouth, tongue, or throat
- Trouble in swallowing or throat tightness
- Itching, skin rash, or pale red bumps on the skin called hives
- Nausea or vomiting
- Dizziness, feeling lightheaded or fainting
- Stomach cramps
- Joint pain
Warnings & Precautions
Who should not use ibandronate?
Allergies to Ingredients. People who are allergic to any of the following should not use ibandronate.
- Ibandronate
- Boniva
- Any of the ingredients in the specific product dispensed
Your pharmacist can tell you all the ingredients in the specific ibandronate products they stock.
Esophagus Problems. Ibandronate tablets should not be taken if you have problems with your esophagus. Ibandronate can cause irritation, inflammation, or sores in your esophagus if you already have esophagus problems.
Unable to Sit Upright or Stand. Ibandronate tablets are not recommended if you cannot sit upright or stand for at least 60 minutes. You need to be able to sit upright or stand for this long to reduce your risk of irritation of the esophagus.
Low Calcium Levels (Hypocalcemia). Ibandronate can cause low calcium levels, also known as hypocalcemia. It should not be used if you have low blood calcium levels.
Kidney Problems. Ibandronate should not be taken if your kidneys are not working as well as they should be. If there is a concern about the health of your kidneys, your healthcare provider may do tests to determine if they are working well enough for you to take this medicine.
What should I know about ibandronate before using it?
Do not take ibandronate unless it has been prescribed to you by a healthcare provider. Take it as prescribed.
Do not share ibandronate with other people, even if they have the same condition as you. It may harm them.
Keep ibandronate out of the reach of children.
If you are taking ibandronate by mouth, take the tablet after you get up for the day. Take it on an empty stomach, at least 60 minutes before the first food or drink (other than plain water) of the day and before taking any other medicines or supplements. Ibandronate will work only if it is taken on an empty stomach.
Do not eat, drink anything except plain water, or take other medicines for at least 60 minutes after taking an ibandronate tablet. Do not take it with mineral water, coffee, tea, soda, or juice. These may make ibandronate not work as well. See the Interactions section for more details.
Swallow the tablet whole with a full glass (6 to 8 ounces) of plain water to lower the risk of irritation of the esophagus. Sit upright or stand when you take an ibandronate tablet and afterwards. Do not lie down for at least 60 minutes after you take it. You may sit, stand, walk, or do other activities where you are upright (like reading).
Do not chew or suck on ibandronate tablets. This could lead to irritation or sores in the mouth or throat.
Your healthcare provider may tell you to take calcium and vitamin D supplements while using ibandronate. Wait at least 60 minutes after taking your ibandronate tablet before taking any other medicines or supplements by mouth.
Your healthcare provider may recommend that you have a dental exam before starting treatment with ibandronate.
Talk with your healthcare provider about how long you should use ibandronate.
What should I tell my healthcare provider before using ibandronate?
Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if ibandronate is right for you.
In particular, make sure that you discuss any of the following.
Problems Absorbing Nutrients. Tell your healthcare provider if you have been told that you have malabsorption syndrome, a condition where you have trouble absorbing minerals in the stomach or intestines. Ibandronate may increase the risk of side effects if you already have this condition.
Esophagus, Stomach, or Intestine Problems. Tell your healthcare provider if you have any problems in your upper digestive tract, including Barrett’s esophagus (a condition where the lining of your esophagus thickens), stomach ulcers, or any inflammation. Risedronate can irritate your digestive tract and worsen these conditions.
Planned Dental Surgery. Tell your healthcare provider if you are planning to undergo any dental treatments, such as tooth extraction or dental implant surgery, while using ibandronate. Certain dental procedures may increase the risk of osteonecrosis of the jaw.
Other Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.
- Trouble swallowing
- Low calcium levels (hypocalcemia)
- Kidney problems
- Poor oral health or dental problems (including use of dentures)
- Cancer
- Blood disorders
Other Medicines and Supplements. Ibandronate may interact with other medicines and supplements. Before using ibandronate, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.
Pregnancy. It is not known if or how Ibandronate could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant.
Breastfeeding. It is not known if ibandronate passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed.
Interactions
Does ibandronate interact with foods or drinks?
Avoid eating food or drinking beverages (including mineral water, coffee, tea, soda, juice, or milk) other than plain water within 60 minutes of taking ibandronate, because this may decrease the amount of medicine your body absorbs and make it not work as well.
It is unknown if drinking alcohol will affect ibandronate.
Does ibandronate interact with other medicines (drug interactions)?
Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.
In particular, make sure that you discuss if you are using any of the following before using ibandronate.
- An antacid, supplement, or vitamin containing calcium, aluminum, magnesium, or iron
- A nonsteroidal anti-inflammatory drug (NSAIDs) such as aspirin, ibuprofen, naproxen, and others, which are contained in many prescription and OTC products for pain, swelling, and fever
- A corticosteroid, which is a medicine for certain inflammatory conditions
- Chemotherapy or radiation for treating cancer
This may not be a complete list of medicines that can interact with ibandronate. Always check with your healthcare provider.
Overdose/Missed Dose
What should I do if I accidentally use too much ibandronate?
If you or someone else has taken too much ibandronate, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222. Do not try to vomit. Do not lie down.
What should I do if I miss a dose of ibandronate?
If you miss a dose of an ibandronate tablet, do not take it later in the day. Contact your healthcare provider for instructions.
If you miss a dose of ibandronate injection, reschedule an appointment with your healthcare provider to receive the injection.
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