Boniva (Generic)

Ibandronate is used to prevent and treat certain types of bone loss (osteoporosis). Osteoporosis causes bones to become thinner and break more easily. Your chance of developing osteoporosis increases after menopause, as you age, or if you take corticosteroid medications (such as prednisone) for long periods.

This medication works by slowing bone loss to help maintain strong bones and reduce the risk of broken bones (fractures). Ibandronate belongs to a class of medications called bisphosphonates.

Read the Medication Guide and, if available, the Patient Information Leaflet before starting this medication and each time you get a refill because new information may be available. Follow the instructions very closely to make sure you absorb as much of the drug as possible and reduce the risk of injury to your esophagus. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth as directed by your doctor, usually once a month on the same date each month. Choose the day of the month that best fits your schedule. Take this medication after getting up for the day, and at least 60 minutes before taking your first food, beverage or other medication. Do not take it at bedtime or while you are still in bed.

Take this medication with a full glass (6 to 8 ounces/180 to 240 milliliters) of plain water. Do not take it with any other beverages. Do not chew or suck the tablet or keep it in your mouth to melt. Swallow the tablet whole. Then stay fully upright (sitting, standing, or walking) for at least 60 minutes and do not lie down until after your first food of the day. Wait at least 60 minutes after taking ibandronate before you eat or drink anything other than plain water and before taking any other medication by mouth.

Medications such as quinapril, certain forms of didanosine (chewable/dispersible buffered tablets or pediatric oral solution), sucralfate, and bismuth subsalicylate may interfere with the absorption of ibandronate. Calcium or iron supplements, vitamins with minerals, and antacids containing calcium, magnesium or aluminum, as well as foods such as dairy products (such as milk, yogurt), mineral water, and calcium-enriched juice, may also interfere with absorption. Do not take these products for at least 60 minutes after taking ibandronate.

Take this medication regularly to get the most benefit from it. Remember to take it on the same day each month. It may help to mark your calendar with a reminder. Talk to your doctor about the risks and benefits of long-term use of this medication.

Continue to take other medications for your condition as directed by your doctor.

Stomach upset, diarrhea, pain in arms/legs, or mild flu-like symptoms (such as fatigue, muscle ache) may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: increased or severe bone/joint/muscle pain, new or unusual hip/thigh/groin pain, jaw pain, vision changes.

This medication may rarely cause irritation and ulcers in your stomach or esophagus. Get medical help right away if any of these serious side effects occur: new/severe/worsening heartburn, chest pain, difficult or painful swallowing, severe stomach/abdominal pain, black/tarry stools, vomit that looks like coffee grounds.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Before taking ibandronate, tell your doctor or pharmacist if you are allergic to it; or to other bisphosphonates (such as alendronate, etidronate, pamidronate, risedronate); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: esophagus problems (such as heartburn, narrowing of the esophagus, achalasia), low blood calcium levels (hypocalcemia), inability to sit upright or stand for 60 minutes, difficult or painful swallowing, stomach/intestinal disorders (such as ulcers), severe kidney disease.

Some people taking ibandronate may have serious jawbone problems. Your doctor should check your mouth before you start this medication. Tell your dentist that you are taking this medication before you have any dental work done. To help prevent jawbone problems, have regular dental exams and learn how to keep your teeth and gums healthy. If you have jaw pain, tell your doctor and dentist right away.

Before having surgery (especially dental procedures), tell your doctor and dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). Your doctor or dentist may tell you to stop taking ibandronate before your surgery. Ask for specific instructions about stopping or starting this medication.

Caution is advised if you are pregnant or planning to become pregnant in the future. This medication may stay in your body for many years. Its effects on an unborn baby are not known. Discuss the risks and benefits with your doctor before starting treatment with ibandronate.

It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medicines away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

See also the How to Use section.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

This medication may interfere with certain laboratory tests (bone-imaging agents), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

If you miss a dose and your next scheduled dose is more than 7 days away, do not take the medication later in the day. Take it the next morning after you remember. Then continue taking your monthly dose in the morning on your originally chosen day of the month. If your next scheduled dose is only 1 to 7 days away, wait until your selected day to take the medication. Do not take two tablets within the same week to catch up. Consult your doctor or pharmacist if you have any questions.

Do not share this medication with others.

Lifestyle changes that help promote healthy bones include increasing weight-bearing exercise, stopping smoking, limiting alcohol, and eating well-balanced meals that contain adequate calcium and vitamin D. You may also need to take calcium and vitamin D supplements and make lifestyle changes. Consult your doctor for specific advice.

Laboratory and/or medical tests (such as bone density tests, x-rays, height, blood mineral levels) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.