Other Names/Brands

Bonviva, Bondronat, Bonevell, Forsoban

Mechanism of Action

Ibandronate is a bisphosphonate medication that works by inhibiting the activity of osteoclasts, the cells responsible for bone tissue breakdown. By inhibiting osteoclasts, ibandronate slows bone resorption, thereby helping to increase bone density and strength.

This medication is commonly used to prevent and treat osteoporosis, especially in postmenopausal women, to reduce the risk of fractures caused by this condition.

Indications

Ibandronate is indicated for the prevention and treatment of osteoporosis in postmenopausal women, with the goal of reducing the risk of vertebral fractures. In some cases, ibandronate may also be used to treat bone loss due to long-term corticosteroid therapy or other conditions that cause increased bone resorption. This medication helps maintain bone density and reduce the risk of fragility fractures.

Contraindications

Ibandronate is contraindicated in patients with hypersensitivity to it or any of its components, as well as in patients with esophageal disorders that impede food emptying, such as strictures or achalasia.

This medication should also not be used in patients who are unable to stand or sit upright for at least 60 minutes after taking the medication, as it may increase the risk of esophageal irritation or ulceration. Furthermore, ibandronate is contraindicated in patients with uncorrected hypocalcemia.

Side Effects

The most common side effects of ibandronate include muscle, bone, or joint pain and digestive problems such as nausea, stomach pain, or stomach discomfort. Some patients may also experience esophageal irritation or inflammation if the medication is not taken as directed.

Other, less common side effects include headache, fatigue, skin rash, and flu-like symptoms. Long-term use, although rare, can cause osteonecrosis of the jaw or atypical fractures of the femur.

Preparations

Ibandronate is available in several dosage forms, including oral tablets and intravenous injection.

• Ibandronate tablets are available in a 150 mg dose taken once a month.
• The injectable preparation contains 3 mg in 3 mL and is administered every three months via intravenous injection by a healthcare professional.

The choice of dosage form and dosage is tailored to the patient's condition, therapeutic goals, and response to treatment.

Dosage

The dose of ibandronate for the treatment of osteoporosis in postmenopausal women is 150 mg taken once a month, at least 60 minutes before meals. For the injectable form, the dose used is 3 mg administered intravenously every three months by a healthcare professional. It is important for patients to remain sitting or standing for 60 minutes after taking the tablet to prevent esophageal irritation and ensure optimal absorption of the drug.

Safety of Drugs

Ibandronate is classified as pregnancy category C by the FDA, meaning that animal studies have shown an adverse effect on the fetus, but there are no controlled studies in humans. Its use in pregnant women is only permitted if the expected benefit outweighs the potential risk to the fetus.

Furthermore, it is not known whether ibandronate is excreted in breast milk, so use in nursing mothers should be done with caution and under medical supervision.

Drug Interactions

Ibandronate can interact with several types of drugs and substances, especially those that interfere with drug absorption from the gastrointestinal tract.

• Calcium, iron, magnesium, or antacid supplements can decrease the absorption of ibandronate if taken concurrently, so it's best to take them at least 60 minutes after ibandronate.
• Concurrent use with nonsteroidal anti-inflammatory drugs (NSAIDs) can increase the risk of irritation or ulceration in the upper gastrointestinal tract.
• Interactions with other drugs that affect mineral levels should also be considered and should be discussed with a doctor.

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