ibandronate (i-ban-dro-nate) Boniva

 Indications

Treatment/prevention of postmenopausal osteoporosis.

Action

Inhibits resorption of bone by inhibiting osteoclast activity.

Therapeutic Effects: Reversal/prevention of

progression of osteoporosis with decreased fractures.

Pharmacokinetics

Absorption: 0.6% absorbed following oral administration

(significantlypby food).

Distribution: Rapidly binds to bone.

Protein Binding: 90.9–99.5%.

Metabolism and Excretion: 50–60% excreted in

urine; unabsorbed drug is eliminated in feces.

Half-life: PO—10–60 hr; IV—4.6–25.5 hr.

TIME/ACTION PROFILE

ROUTE ONSET PEAK DURATION

PO unknown 0.5–2 hr up to 1 mo

IV unknown 3 hr up to 3 mo

Contraindications/Precautions

Contraindicated in: Hypersensitivity; Abnormalities

of the esophagus which delay esophageal emptying

(i.e. strictures, achalasia); Uncorrected hypocalcemia;

Inability to stand/sit upright for at least 60 min; CCr

30 mL/min.

Use Cautiously in: History of upper GI disorders;

Concurrent use of NSAIDs or aspirin; Invasive dental

procedures, cancer, receiving chemotherapy, corticosteroids,

or angiogenesis inhibitors, poor oral hygiene,

periodontal disease, dental disease, anemia, coagulopathy,

infection, or poorly-fitting dentures (mayqrisk of

jaw osteonecrosis); OB: Use only if potential benefit

outweighs risks to mother and fetus; Lactation: Lactation;

Pedi: Children 18 yr (safety not established);

Geri: Consider age relatedpin body mass, renal and

hepatic function, concurrent disease states and drug

therapy.

Adverse Reactions/Side Effects

GI: diarrhea, dyspepsia, dysphagia, esophageal cancer,

esophagitis, esophageal/gastric ulcer. MS: musculoskeletal

pain, pain in arms/legs, femur fractures, osteonecrosis

(primarily of jaw). Derm: ERYTHEMA MULTIFORME,

STEVENS-JOHNSON SYNDROME. Resp: asthma

exacerbation. Misc: ANAPHYLAXIS, injection site reactions.

Interactions

Drug-Drug: Calcium-, aluminum-, magnesium-,

and iron- containing products, including antacidsp

absorption (ibandronate should be taken 60 min before).

Concurrent use of NSAIDs including aspirin,

mayqrisk of gastric irritation.

Drug-Food: Milk and other foodspabsorption.

Route/Dosage

PO (Adults): 150 mg once monthly.

IV (Adults): 3mg every 3 mo.

Availability (generic available)

Tablets: 150 mg. Injection: 3 mg/3 mL in prefilled

single-use syringe.