Boniva

Generic Name: ibandronate (oral/injection) (eye BAN dro nate)
Brand Names: Boniva

What is Boniva?

Boniva belongs to a group of medicines called bisphosphonates (bis FOS fo nayts). It alters the cycle of bone formation and breakdown in the body. Ibandronate slows bone loss while increasing bone mass, which may prevent bone fractures.

Boniva is used to treat or prevent osteoporosis in women after menopause.

Boniva may also be used for purposes not listed in this medication guide.

Important information

You should not use Boniva if you have severe kidney disease, low blood levels of calcium (hypocalcemia), or a problem with your esophagus (the tube that connects your mouth and stomach).

 Osteoporosis: A Battle For Your Bones

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Osteoporosis: A Battle For Your Bones

Do not take an Boniva tablet if you cannot sit upright or stand for at least one full hour after taking the medicine. Ibandronate can cause serious problems in the stomach or esophagus. You will need to stay upright for at least 60 minutes after taking this medication.

Before taking this medicine

You should not use Boniva if you are allergic to ibandronate, or if you have:

severe kidney disease;

low blood levels of calcium (hypocalcemia); or

a problem with your esophagus (the tube that connects your mouth and stomach).

Do not take an Boniva tablet if you cannot sit upright or stand for at least one full hour. Ibandronate can cause serious problems in the stomach or esophagus. You will need to stay upright for at least 60 minutes after taking this medication.

To make sure Boniva is safe for you, tell your doctor if you have:

a vitamin D deficiency;

kidney disease;

an ulcer in your stomach or esophagus; or

trouble swallowing.

In rare cases, Boniva may cause bone loss (osteonecrosis) in the jaw. Symptoms include jaw pain or numbness, red or swollen gums, loose teeth, or slow healing after dental work. The longer you use Boniva, the more likely you are to develop this condition.

Osteonecrosis of the jaw may be more likely if you have cancer or received chemotherapy, radiation, or steroids. Other risk factors include blood clotting disorders, anemia (low red blood cells), and a pre existing dental problem.

Talk with your doctor about the risks and benefits of using this medication.

It is not known whether Boniva will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether ibandronate passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

How should I use Boniva?

Use Boniva exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Boniva tablets are taken either once each day or once each month. The intravenous solution is given as an injection into one of your veins once every 3 months. A healthcare provider will give you this injection. The tablets can be taken at home.

Take the Boniva tablet first thing in the morning, at least 1 hour (60 minutes) before you eat or drink anything or take any other medicine. If you take a tablet only once a month, take it on the same day each month and always first thing in the morning.

Take each Boniva tablet with a full glass (6 to 8 ounces) of water. Use only plain water (not mineral water) when taking a tablet.

Do not crush, cut, chew, or suck the Boniva tablet. Swallow the tablet whole.

For at least 1 full hour after taking an Boniva tablet:

Do not lie down or recline.

Do not eat or drink anything other than plain water.

Do not take any other medicine including vitamins, calcium, or antacids. Talk with your doctor about the best dosing schedule for your other medicines.

To be sure Boniva is helping your condition, your bone mineral density will need to be tested often. You may not need to take this medicine for longer than 3 to 5 years.

If you need to have any dental work (especially surgery), tell the dentist ahead of time that you are using Boniva. You may need to stop using the medicine for a short time.

Boniva is only part of a complete program of treatment that may also include diet changes, exercise, and taking calcium and vitamin supplements. Follow your diet, medication, and exercise routines very closely.

Store at room temperature away from moisture and heat.

Boniva dosing information

Usual Adult Dose for Osteoporosis:

Oral:

150 mg orally once a month on the same day each month

IV Injection:

3 mg by IV injection over 15 to 30 seconds every three months.

Comments:

-The IV injection should not be administered more frequently than once every 3 months.

-Obtain serum creatinine prior administration of each IV injection.

-Perform a routine oral examination prior administration of IV injection

Uses: Treatment and prevention of postmenopausal osteoporosis, to increase bone mineral density (BMD) and to reduce the incidence of vertebral fractures

Usual Adult Dose for Prevention of Osteoporosis:

Oral:

150 mg orally once a month on the same day each month

IV Injection:

3 mg by IV injection over 15 to 30 seconds every three months.

Comments:

-The IV injection should not be administered more frequently than once every 3 months.

-Obtain serum creatinine prior administration of each IV injection.

-Perform a routine oral examination prior administration of IV injection

Uses: Treatment and prevention of postmenopausal osteoporosis, to increase bone mineral density (BMD) and to reduce the incidence of vertebral fractures

See also: Dosage Information (in more detail)

What happens if I miss a dose?

If you take Boniva tablets once daily: If you forget to take this medicine first thing in the morning, do not take it later in the day. Wait until the following morning to take the medicine and skip the missed dose. Do not take two (2) tablets in one day.

If you take Boniva tablets once a month: If you forget to take the tablet on your scheduled day, take it first thing in the morning on the day after you remember the missed dose. Then return to your regular monthly schedule on your chosen dose day. If your next scheduled dose is less than 7 days away, wait until then to take the medicine and skip the missed dose. Do not take two (2) tablets in one week.

If you receive ibandronate injections every 3 months: Call your doctor for instructions if you miss an appointment for your injection.

What happens if I overdose?

Drink a full glass of milk and seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Do not make yourself vomit and do not lie down.

Overdose symptoms may include nausea, heartburn, stomach pain, diarrhea, muscle cramps, numbness or tingling, tight muscles in your face, seizure (convulsions), irritability, and unusual thoughts or behavior.

What should I avoid while taking Boniva?

Do not take any other medicines including vitamins, calcium, or antacids for at least 60 minutes before or after taking an Boniva tablet.

Avoid milk and other dairy products for at least 60 minutes after taking ibandronate (except in the case of overdose as stated above).

Boniva side effects

Get emergency medical help if you have signs of an allergic reaction to Boniva: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using Boniva and call your doctor at once if you have:

chest pain, new or worsening heartburn;

difficulty or pain when swallowing;

pain or burning under the ribs or in the back;

severe joint, bone, or muscle pain;

new or unusual pain in your thigh or hip; or

jaw pain, numbness, or swelling.

Common Boniva side effects may include:

back pain, headache;

redness or swelling of your eyes;

diarrhea;

flu symptoms;

redness or swelling where the medicine was injected;

nausea or upset stomach; or

pain in your arms or legs.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Boniva?

Tell your doctor about all your current medicines and any you start or stop using, especially:

aspirin or other NSAIDs (nonsteroidal anti-inflammatory drugs) - ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

This list is not complete. Other drugs may interact with ibandronate, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.