Ibandronate
Brand names: Boniva
Drug class:
Antineoplastic Agents
Usage of Ibandronate
Osteoporosis
Prevention of osteoporosis in postmenopausal women. Risk factors for postmenopausal osteoporosis and related fractures include early menopause, advanced age, low bone mineral density (BMD), low body mass index (BMI), previous fracture or family history of fracture/osteoporosis, excessive alcohol intake, smoking, inadequate physical activity, low calcium and vitamin D intake, certain drugs (e.g., glucocorticoids), and medical conditions or diseases (e.g., rheumatoid arthritis, diabetes mellitus, Cushing syndrome, hyperparathyroidism).
Treatment of osteoporosis in postmenopausal women.
In addition to adequate intake of calcium/vitamin D and other lifestyle modifications (e.g., exercise, avoidance of excessive alcohol and tobacco use), experts recommend that pharmacologic therapy for osteoporosis be considered in postmenopausal women with previous hip or vertebral fractures or low BMD; pharmacologic therapy also may be considered in postmenopausal women with low bone mass, although there is less evidence supporting overall fracture risk reduction in such patients.
Use of a drug with proven efficacy in reducing fracture risk is recommended; bisphosphonates (e.g., alendronate, risedronate, zoledronic acid, ibandronate) are recommended as one of several first-line drugs.
Individualize choice of therapy based on potential benefits (with respect to fracture risk reduction) and adverse effects of therapy, patient preferences, comorbidities, and risk factors.
Glucocorticoid-induced Osteoporosis
Also has been used in the management of glucocorticoid-induced osteoporosis† [off-label].
American College of Rheumatology (ACR) recommends optimizing calcium and vitamin D intake and lifestyle modifications (e.g., diet, smoking cessation, weight-bearing or resistance-training exercise) in all patients receiving long-term glucocorticoid therapy; in addition, pharmacologic therapy with an oral bisphosphonate is recommended in patients who are considered to be at moderate-to-high risk of fracture. Oral bisphosphonates generally are preferred because of their demonstrated antifracture benefits, safety, and low cost.
Relate drugs
- Abemaciclib (Systemic)
- Acyclovir (Systemic)
- Adenovirus Vaccine
- Aldomet
- Aluminum Acetate
- Aluminum Chloride (Topical)
- Ambien
- Ambien CR
- Aminosalicylic Acid
- Anacaulase
- Anacaulase
- Anifrolumab (Systemic)
- Antacids
- Anthrax Immune Globulin IV (Human)
- Antihemophilic Factor (Recombinant), Fc fusion protein (Systemic)
- Antihemophilic Factor (recombinant), Fc-VWF-XTEN Fusion Protein
- Antihemophilic Factor (recombinant), PEGylated
- Antithrombin alfa
- Antithrombin alfa
- Antithrombin III
- Antithrombin III
- Antithymocyte Globulin (Equine)
- Antivenin (Latrodectus mactans) (Equine)
- Apremilast (Systemic)
- Aprepitant/Fosaprepitant
- Articaine
- Asenapine
- Atracurium
- Atropine (EENT)
- Avacincaptad Pegol (EENT)
- Avacincaptad Pegol (EENT)
- Axicabtagene (Systemic)
- Clidinium
- Clindamycin (Systemic)
- Clonidine
- Clonidine (Epidural)
- Clonidine (Oral)
- Clonidine injection
- Clonidine transdermal
- Co-trimoxazole
- COVID-19 Vaccine (Janssen) (Systemic)
- COVID-19 Vaccine (Moderna)
- COVID-19 Vaccine (Pfizer-BioNTech)
- Crizanlizumab-tmca (Systemic)
- Cromolyn (EENT)
- Cromolyn (Systemic, Oral Inhalation)
- Crotalidae Polyvalent Immune Fab
- CycloSPORINE (EENT)
- CycloSPORINE (EENT)
- CycloSPORINE (Systemic)
- Cysteamine Bitartrate
- Cysteamine Hydrochloride
- Cysteamine Hydrochloride
- Cytomegalovirus Immune Globulin IV
- A1-Proteinase Inhibitor
- A1-Proteinase Inhibitor
- Bacitracin (EENT)
- Baloxavir
- Baloxavir
- Bazedoxifene
- Beclomethasone (EENT)
- Beclomethasone (Systemic, Oral Inhalation)
- Belladonna
- Belsomra
- Benralizumab (Systemic)
- Benzocaine (EENT)
- Bepotastine
- Betamethasone (Systemic)
- Betaxolol (EENT)
- Betaxolol (Systemic)
- Bexarotene (Systemic)
- Bismuth Salts
- Botulism Antitoxin (Equine)
- Brimonidine (EENT)
- Brivaracetam
- Brivaracetam
- Brolucizumab
- Brompheniramine
- Budesonide (EENT)
- Budesonide (Systemic, Oral Inhalation)
- Bulk-Forming Laxatives
- Bupivacaine (Local)
- BuPROPion (Systemic)
- Buspar
- Buspar Dividose
- Buspirone
- Butoconazole
- Cabotegravir (Systemic)
- Caffeine/Caffeine and Sodium Benzoate
- Calcitonin
- Calcium oxybate, magnesium oxybate, potassium oxybate, and sodium oxybate
- Calcium Salts
- Calcium, magnesium, potassium, and sodium oxybates
- Candida Albicans Skin Test Antigen
- Cantharidin (Topical)
- Capmatinib (Systemic)
- Carbachol
- Carbamide Peroxide
- Carbamide Peroxide
- Carmustine
- Castor Oil
- Catapres
- Catapres-TTS
- Catapres-TTS-1
- Catapres-TTS-2
- Catapres-TTS-3
- Ceftolozane/Tazobactam (Systemic)
- Cefuroxime
- Centruroides Immune F(ab′)2
- Cetirizine (EENT)
- Charcoal, Activated
- Chloramphenicol
- Chlorhexidine (EENT)
- Chlorhexidine (EENT)
- Cholera Vaccine Live Oral
- Choriogonadotropin Alfa
- Ciclesonide (EENT)
- Ciclesonide (Systemic, Oral Inhalation)
- Ciprofloxacin (EENT)
- Citrates
- Dacomitinib (Systemic)
- Dapsone (Systemic)
- Dapsone (Systemic)
- Daridorexant
- Darolutamide (Systemic)
- Dasatinib (Systemic)
- DAUNOrubicin and Cytarabine
- Dayvigo
- Dehydrated Alcohol
- Delafloxacin
- Delandistrogene Moxeparvovec (Systemic)
- Dengue Vaccine Live
- Dexamethasone (EENT)
- Dexamethasone (Systemic)
- Dexmedetomidine
- Dexmedetomidine
- Dexmedetomidine
- Dexmedetomidine (Intravenous)
- Dexmedetomidine (Oromucosal)
- Dexmedetomidine buccal/sublingual
- Dexmedetomidine injection
- Dextran 40
- Diclofenac (Systemic)
- Dihydroergotamine
- Dimethyl Fumarate (Systemic)
- Diphenoxylate
- Diphtheria and Tetanus Toxoids
- Diphtheria and Tetanus Toxoids and Acellular Pertussis Vaccine Adsorbed
- Diroximel Fumarate (Systemic)
- Docusate Salts
- Donislecel-jujn (Systemic)
- Doravirine, Lamivudine, and Tenofovir Disoproxil
- Doxepin (Systemic)
- Doxercalciferol
- Doxycycline (EENT)
- Doxycycline (Systemic)
- Doxycycline (Systemic)
- Doxylamine
- Duraclon
- Duraclon injection
- Dyclonine
- Edaravone
- Edluar
- Efgartigimod Alfa (Systemic)
- Eflornithine
- Eflornithine
- Elexacaftor, Tezacaftor, And Ivacaftor
- Elranatamab (Systemic)
- Elvitegravir, Cobicistat, Emtricitabine, and tenofovir Disoproxil Fumarate
- Emicizumab-kxwh (Systemic)
- Emtricitabine and Tenofovir Disoproxil Fumarate
- Entrectinib (Systemic)
- EPINEPHrine (EENT)
- EPINEPHrine (Systemic)
- Erythromycin (EENT)
- Erythromycin (Systemic)
- Estrogen-Progestin Combinations
- Estrogen-Progestin Combinations
- Estrogens, Conjugated
- Estropipate; Estrogens, Esterified
- Eszopiclone
- Ethchlorvynol
- Etranacogene Dezaparvovec
- Evinacumab (Systemic)
- Evinacumab (Systemic)
- Factor IX (Human), Factor IX Complex (Human)
- Factor IX (Recombinant)
- Factor IX (Recombinant), albumin fusion protein
- Factor IX (Recombinant), Fc fusion protein
- Factor VIIa (Recombinant)
- Factor Xa (recombinant), Inactivated-zhzo
- Factor Xa (recombinant), Inactivated-zhzo
- Factor XIII A-Subunit (Recombinant)
- Faricimab
- Fecal microbiota, live
- Fedratinib (Systemic)
- Fenofibric Acid/Fenofibrate
- Fibrinogen (Human)
- Flunisolide (EENT)
- Fluocinolone (EENT)
- Fluorides
- Fluorouracil (Systemic)
- Flurbiprofen (EENT)
- Flurbiprofen (EENT)
- Flurbiprofen (EENT)
- Flurbiprofen (EENT)
- Fluticasone (EENT)
- Fluticasone (Systemic, Oral Inhalation)
- Fluticasone and Vilanterol (Oral Inhalation)
- Ganciclovir Sodium
- Gatifloxacin (EENT)
- Gentamicin (EENT)
- Gentamicin (Systemic)
- Gilteritinib (Systemic)
- Glofitamab
- Glycopyrronium
- Glycopyrronium
- Gonadotropin, Chorionic
- Goserelin
- Guanabenz
- Guanadrel
- Guanethidine
- Guanfacine
- Haemophilus b Vaccine
- Hepatitis A Virus Vaccine Inactivated
- Hepatitis B Vaccine Recombinant
- Hetlioz
- Hetlioz LQ
- Homatropine
- Hydrocortisone (EENT)
- Hydrocortisone (Systemic)
- Hydroquinone
- Hylorel
- Hyperosmotic Laxatives
- Ibandronate
- Igalmi buccal/sublingual
- Imipenem, Cilastatin Sodium, and Relebactam
- Inclisiran (Systemic)
- Infliximab, Infliximab-dyyb
- Influenza Vaccine Live Intranasal
- Influenza Vaccine Recombinant
- Influenza Virus Vaccine Inactivated
- Inotuzumab
- Insulin Human
- Interferon Alfa
- Interferon Beta
- Interferon Gamma
- Intermezzo
- Intuniv
- Iodoquinol (Topical)
- Iodoquinol (Topical)
- Ipratropium (EENT)
- Ipratropium (EENT)
- Ipratropium (Systemic, Oral Inhalation)
- Ismelin
- Isoproterenol
- Ivermectin (Systemic)
- Ivermectin (Topical)
- Ixazomib Citrate (Systemic)
- Japanese Encephalitis Vaccine
- Kapvay
- Ketoconazole (Systemic)
- Ketorolac (EENT)
- Ketorolac (EENT)
- Ketorolac (EENT)
- Ketorolac (EENT)
- Ketorolac (Systemic)
- Ketotifen
- Lanthanum
- Lecanemab
- Lefamulin
- Lemborexant
- Lenacapavir (Systemic)
- Leniolisib
- Letermovir
- Letermovir
- Levodopa/Carbidopa
- LevoFLOXacin (EENT)
- LevoFLOXacin (Systemic)
- L-Glutamine
- Lidocaine (Local)
- Lidocaine (Systemic)
- Linezolid
- Lofexidine
- Loncastuximab
- Lotilaner (EENT)
- Lotilaner (EENT)
- Lucemyra
- Lumasiran Sodium
- Lumryz
- Lunesta
- Mannitol
- Mannitol
- Mb-Tab
- Measles, Mumps, and Rubella Vaccine
- Mecamylamine
- Mechlorethamine
- Mechlorethamine
- Melphalan (Systemic)
- Meningococcal Groups A, C, Y, and W-135 Vaccine
- Meprobamate
- Methoxy Polyethylene Glycol-epoetin Beta (Systemic)
- Methyldopa
- Methylergonovine, Ergonovine
- MetroNIDAZOLE (Systemic)
- MetroNIDAZOLE (Systemic)
- Miltown
- Minipress
- Minocycline (EENT)
- Minocycline (Systemic)
- Minoxidil (Systemic)
- Mometasone
- Mometasone (EENT)
- Moxifloxacin (EENT)
- Moxifloxacin (Systemic)
- Nalmefene
- Naloxone (Systemic)
- Natrol Melatonin + 5-HTP
- Nebivolol Hydrochloride
- Neomycin (EENT)
- Neomycin (Systemic)
- Netarsudil Mesylate
- Nexiclon XR
- Nicotine
- Nicotine
- Nicotine
- Nilotinib (Systemic)
- Nirmatrelvir
- Nirmatrelvir
- Nitroglycerin (Systemic)
- Ofloxacin (EENT)
- Ofloxacin (Systemic)
- Oliceridine Fumarate
- Olipudase Alfa-rpcp (Systemic)
- Olopatadine
- Omadacycline (Systemic)
- Osimertinib (Systemic)
- Oxacillin
- Oxymetazoline
- Pacritinib (Systemic)
- Palovarotene (Systemic)
- Paraldehyde
- Peginterferon Alfa
- Peginterferon Beta-1a (Systemic)
- Penicillin G
- Pentobarbital
- Pentosan
- Pilocarpine Hydrochloride
- Pilocarpine, Pilocarpine Hydrochloride, Pilocarpine Nitrate
- Placidyl
- Plasma Protein Fraction
- Plasminogen, Human-tmvh
- Pneumococcal Vaccine
- Polymyxin B (EENT)
- Polymyxin B (Systemic, Topical)
- PONATinib (Systemic)
- Poractant Alfa
- Posaconazole
- Potassium Supplements
- Pozelimab (Systemic)
- Pramoxine
- Prazosin
- Precedex
- Precedex injection
- PrednisoLONE (EENT)
- PrednisoLONE (Systemic)
- Progestins
- Propylhexedrine
- Protamine
- Protein C Concentrate
- Protein C Concentrate
- Prothrombin Complex Concentrate
- Pyrethrins with Piperonyl Butoxide
- Quviviq
- Ramelteon
- Relugolix, Estradiol, and Norethindrone Acetate
- Remdesivir (Systemic)
- Respiratory Syncytial Virus Vaccine, Adjuvanted (Systemic)
- RifAXIMin (Systemic)
- Roflumilast (Systemic)
- Roflumilast (Topical)
- Roflumilast (Topical)
- Rotavirus Vaccine Live Oral
- Rozanolixizumab (Systemic)
- Rozerem
- Ruxolitinib (Systemic)
- Saline Laxatives
- Selenious Acid
- Selexipag
- Selexipag
- Selpercatinib (Systemic)
- Sirolimus (Systemic)
- Sirolimus, albumin-bound
- Smallpox and Mpox Vaccine Live
- Smallpox Vaccine Live
- Sodium Chloride
- Sodium Ferric Gluconate
- Sodium Nitrite
- Sodium oxybate
- Sodium Phenylacetate and Sodium Benzoate
- Sodium Thiosulfate (Antidote) (Systemic)
- Sodium Thiosulfate (Protectant) (Systemic)
- Somatrogon (Systemic)
- Sonata
- Sotorasib (Systemic)
- Suvorexant
- Tacrolimus (Systemic)
- Tafenoquine (Arakoda)
- Tafenoquine (Krintafel)
- Talquetamab (Systemic)
- Tasimelteon
- Tedizolid
- Telotristat
- Tenex
- Terbinafine (Systemic)
- Tetrahydrozoline
- Tezacaftor and Ivacaftor
- Theophyllines
- Thrombin
- Thrombin Alfa (Recombinant) (Topical)
- Timolol (EENT)
- Timolol (Systemic)
- Tixagevimab and Cilgavimab
- Tobramycin (EENT)
- Tobramycin (Systemic)
- TraMADol (Systemic)
- Trametinib Dimethyl Sulfoxide
- Trancot
- Tremelimumab
- Tretinoin (Systemic)
- Triamcinolone (EENT)
- Triamcinolone (Systemic)
- Trimethobenzamide
- Tucatinib (Systemic)
- Unisom
- Vaccinia Immune Globulin IV
- Valoctocogene Roxaparvovec
- Valproate/Divalproex
- Valproate/Divalproex
- Vanspar
- Varenicline (Systemic)
- Varenicline (Systemic)
- Varenicline Tartrate (EENT)
- Vecamyl
- Vitamin B12
- Vonoprazan, Clarithromycin, and Amoxicillin
- Wytensin
- Xyrem
- Xywav
- Zaleplon
- Zirconium Cyclosilicate
- Zolpidem
- Zolpidem (Oral)
- Zolpidem (Oromucosal, Sublingual)
- ZolpiMist
- Zoster Vaccine Recombinant
- 5-hydroxytryptophan, melatonin, and pyridoxine
How to use Ibandronate
General
Administration
Oral Administration
Administer orally with a full glass (180–240 mL) of plain water ≥60 minutes prior to the first food, beverage (other than plain water), or other orally administered drug or supplement (including vitamins, antacids, and calcium) of the day. (See Food under Pharmacokinetics.)
Avoid lying down for ≥60 minutes following administration.
Do not to suck or chew tablets; potential for oropharyngeal ulceration. (See Upper GI Effects under Cautions.)
If a morning daily oral dose is missed, do not take missed dose later that SAMe day. Resume the regular schedule the next day.
When administered monthly, take tablets in the morning on the same day each month. If a monthly dose is missed and the next scheduled dose is more than 7 days away, take the missed dose the next morning after it is remembered and resume the regular schedule. If the next scheduled dose is 1–7 days away, maintain the regular schedule; do not take more than one 150-mg tablet within the same week.
IV Administration
Administer by IV injection once every 3 months by a health-care professional.
Injection must only be administered IV. Safety and efficacy of IV injection administered by other routes not established.
Because of the risk of anaphylaxis or other severe hypersensitivity Reactions, appropriate medical support should be readily available during IV administration. (See Hypersensitivity under Cautions.)
If a dose is missed, reschedule administration with a health-care professional as soon as possible. Schedule subsequent injections at 3-month intervals; should not be administered more often than once every 3 months.
Administration RisksTake care to avoid intra-arterial or paravenous injection as such administration could result in tissue damage.
Rate of AdministrationAdminister IV over a period of 15–30 seconds.
DoSage
Available as ibandronate sodium (as the monosodium monohydrate); dosage expressed in terms of ibandronate.
Adults
Osteoporosis Prevention in Postmenopausal Women Oral150 mg once monthly.
Osteoporosis Treatment in Postmenopausal Women Oral150 mg once monthly.
Optimal duration of treatment not established. Safety and efficacy based on data over 3 years. Reevaluate need for continued therapy periodically in all patients receiving bisphosphonates. Consider discontinuance of bisphosphonate therapy after 3–5 years in patients at low risk of fracture. Evaluate fracture risk periodically in patients who discontinue therapy.
IV3 mg once every 3 months.
Optimal duration of treatment not established. Safety and efficacy of IV ibandronate based on data supporting fracture reduction over 1 year of treatment. Reevaluate need for continued therapy periodically in all patients receiving bisphosphonates. Consider discontinuance of bisphosphonate therapy after 3–5 years in patients at low risk of fracture. Evaluate fracture risk periodically in patients who discontinue therapy.
Special Populations
Renal Impairment
Oral or IVDosage adjustments not necessary in patients with mild to moderate renal impairment (Clcr ≥30 mL/minute); use not recommended in patients with severe renal impairment (Clcr <30 mL/minute).
Warnings
Contraindications
Oral and IV: Known hypersensitivity to ibandronate or any ingredient in the formulation.
Warnings/Precautions
Upper GI Effects
Possible severe adverse esophageal effects (e.g., esophagitis, esophageal ulcers, erosions, strictures, perforation). (See Oral Administration under Dosage and Administration.) Monitor for any manifestations and discontinue if dysphagia, odynophagia, new or worsening heartburn, or retrosternal pain occurs.
Use with caution in patients with active upper GI disease (e.g., Barrett’s esophagus, dysphagia, other esophageal diseases, gastritis, duodenitis, ulcers). Gastric and duodenal ulcers (some severe and with complications) reported during postmarketing experience.
Route of Administration
Injection must be administered IV by a health-care professional; do not administer by non-IV (e.g., intra-arterial) routes. (See Administration Risks under Dosage and Administration.)
Metabolic Effects
Correct hypocalcemia, hypovitaminosis D, and other disturbances of bone and mineral metabolism before initiating therapy.
If daily intake inadequate, administer supplemental calcium and vitamin D.
Osteonecrosis of the Jaw
Osteonecrosis and osteomyelitis of the jaw reported in patients receiving bisphosphonates. Most cases associated with tooth extraction and/or local infection with delayed healing. Known risk factors include cancer, concomitant therapies (e.g., chemotherapy, corticosteroids, angiogenesis inhibitors), poor oral hygiene, and comorbid disorders (e.g., periodontal and/or other preexisting dental disease, anemia, coagulopathy, infection, ill-fitting dentures). Risk also may be increased with increased duration of bisphosphonate use.
If osteonecrosis of the jaw develops, consult an oral surgeon for treatment. Dental surgery may exacerbate condition.
In patients requiring dental procedures, discontinuance of therapy prior to procedure may reduce the risk of osteonecrosis of the jaw. Base management of patients requiring dental treatment on an individual assessment of risks and benefits.
Musculoskeletal Pain
Severe and occasionally incapacitating bone, joint, and/or muscle pain reported infrequently with bisphosphonate therapy. Time to onset varied from 1 day to years (mean onset about 3 months) after treatment initiation. If severe symptoms occur, consider discontinuing drug. Such pain generally improves following discontinuance, but may recur upon subsequent rechallenge with the same drug or another bisphosphonate.
Atypical Fracture of the Femur
Atypical (subtrochanteric or diaphyseal) femur fractures reported rarely with long-term use (>3 years) of bisphosphonates, mostly in patients receiving these drugs for osteoporosis. Often occurs with minimal or no trauma, and may be bilateral. Causality not established; atypical fractures also occur in osteoporotic patients not receiving bisphosphonates. Risk may be increased with concomitant use of glucocorticoid, estrogen, and proton-pump inhibitor therapy.
Evaluate patients who present with new thigh or groin pain for possibility of an atypical femoral fracture; include assessment of the contralateral limb. Consider interruption of bisphosphonate therapy in patients with manifestations of possible femoral fracture; weigh risks versus benefits of continued treatment. Discontinue if a femoral shaft fracture is cOnfirmed.
Atrial Fibrillation
Although data are conflicting, possible increased risk of atrial fibrillation with use of bisphosphonates. FDA analysis of data from long-term (6 months to 3 years) controlled trials identified a higher rate of atrial fibrillation in patients receiving bisphosphonates (alendronate, ibandronate, risedronate, or zoledronic acid) versus placebo; however, only a few events reported in each study. FDA is continuing to monitor this safety concern.
Potential Risk of Esophageal Cancer
Some evidence (from postmarketing experience and observational studies) suggests a possible association between use of oral bisphosphonates and an increased risk of esophageal cancer. However, because of conflicting data, additional study needed to confirm such findings.
FDA states that benefits of oral bisphosphonates continue to outweigh their potential risks in patients with osteoporosis; it is important to consider that esophageal cancer is rare, especially in women.
Avoidance of oral bisphosphonates in patients with Barrett’s esophagus, a known precUrsor to esophageal adenocarcinoma, has been recommended.
Renal Effects
Possible renal toxicity (e.g., deterioration of renal function and, rarely, renal failure) with bisphosphonates. Risk may be greater in patients with coexisting conditions associated with renal impairment, concomitant therapy with other nephrotoxic drugs, preexisting renal disease, dehydration, dosage, infusion volume and rate, and multiple cycles of treatment. Assess renal function in such patients.
Use not recommended in patients with severe renal impairment (Clcr <30 mL/minute).
Measure Scr prior to each IV dose. Withhold treatment if deterioration of renal function occurs.
Sensitivity Reactions
HypersensitivityHypersensitivity reactions, including fatal anaphylaxis in patients who received ibandronate injection, reported. (See Contraindications under Cautions and see IV Administration under Dosage and Administration.)
Specific Populations
PregnancyNo data in pregnant women to inform any drug-associated risks. In reproductive animal studies, maternal and fetal toxicity (including postimplantation loss, developmental anomalies, and deaths) observed.
LactationDistributed into milk in rats; not known whether distributed into human milk. Also not known whether the drug has any effects on the nursing infant or milk production.
Pediatric UseSafety and efficacy not established in children. Not indicated for use in children.
Geriatric UseNo substantial differences in safety and efficacy relative to younger adults, but increased sensitivity cannot be ruled out. Consider age-related decreases in renal function.
Renal ImpairmentUse not recommended in patients with severe renal impairment (CLcr <30 mL/minute).
Common Adverse Effects
Oral: Back pain, dyspepsia, pain in the extremities, diarrhea, headache, myalgia.
IV: Arthralgia, back pain, abdominal pain.
What other drugs will affect Ibandronate
Does not induce or inhibit CYP isoenzymes (i.e., CYP1A2, 2A6, 2C9, 2C19, 2D6, 2E1, or 3A4) and is not metabolized.
Antacids or Mineral Supplements Containing Divalent Cations
Pharmacokinetic interaction (decreased absorption of ibandronate) when tablets are used concomitantly with antacids or mineral supplements containing divalent cations (e.g., aluminum, calcium, Magnesium, iron). Administer tablets ≥60 minutes prior to such drugs or supplements.
Drugs Affecting Hepatic Microsomal Enzymes
Pharmacokinetic interactions unlikely.
Drugs Excreted through Renal Tubular Transport
Based on limited data in animals, not excreted through renal tubular transport. Pharmacokinetic interaction unlikely.
Nephrotoxic Agents
Potential pharmacologic interaction (increased risk of renal toxicity). Assess patients taking concomitant nephrotoxic agents. (See Renal Effects under Cautions.)
Specific Drugs and Tests
Drug
Interaction
Comments
Bone-imaging agents
Potential to interfere with use of bone-imaging agents
Histamine H2-receptor antagonists
Increased oral bioavailability of ibandronate
No evidence of increased adverse upper GI effects
Not considered clinically important
Melphalan
Pharmacokinetic interaction unlikely with IV ibandronate
NSAIAs
No evidence of increased adverse upper GI effects
Use concomitantly with caution
Prednisolone
Pharmacokinetic interaction unlikely with IV ibandronate
Pharmacokinetic interaction unlikely with IV ibandronate
Disclaimer
Every effort has been made to ensure that the information provided by Drugslib.com is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Drugslib.com information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Drugslib.com does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Drugslib.com's drug information does not endorse drugs, diagnose patients or recommend therapy. Drugslib.com's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners.
The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Drugslib.com does not assume any responsibility for any aspect of healthcare administered with the aid of information Drugslib.com provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Popular Keywords
- metformin obat apa
- alahan panjang
- glimepiride obat apa
- takikardia adalah
- erau ernie
- pradiabetes
- besar88
- atrofi adalah
- kutu anjing
- trakeostomi
- mayzent pi
- enbrel auto injector not working
- enbrel interactions
- lenvima life expectancy
- leqvio pi
- what is lenvima
- lenvima pi
- empagliflozin-linagliptin
- encourage foundation for enbrel
- qulipta drug interactions