Precautions and Warnings With Ibandronate

To help ensure a safe treatment process, make sure you are aware of the precautions and warnings with ibandronate. The drug may cause osteonecrosis of the jaw, damage to the esophagus and stomach, and extreme muscle or bone pain. Precautions and warnings with ibandronate also extend to people who are allergic to any components of the medicine, have low blood calcium, or cannot sit or stand for an hour.

 

Ibandronate: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking ibandronate sodium (Boniva®) if you:
 
  • Have low blood calcium (hypocalcemia)
  • Cannot sit or stand for one hour
  • Have kidney disease, including kidney failure (renal failure)
  • Have difficulty swallowing or other problems with your esophagus
  • Have any allergies, including allergies to food, dyes, or preservatives.
     
Also, let your healthcare provider know if you are:
 
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding
  • Planning to have a dental procedure.
     
Make sure to tell your healthcare provider about all medicines you may be taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
 

Specific Precautions and Warnings With Ibandronate

Warnings and precautions to be aware of prior to taking ibandronate include the following:
 
  • Ibandronate, like all bisphosphonate medications, can irritate or damage the esophagus and stomach. This can lead to indigestion, heartburn, or even ulcers. Let your healthcare provider know if you notice any of these problems while taking the drug.
     
  • It is important to get enough calcium and vitamin D (either through your diet or by supplementation). Calcium and vitamin D are necessary for rebuilding bone and preventing further bone loss.
     
  • Ibandronate may not be recommended for people with severe kidney disease.
     
  • In rare cases, bisphosphonates (including ibandronate) have caused a condition called osteonecrosis of the jaw. This is a serious, possibly disfiguring, problem in which the bone of the jaw dies. Often, there are symptoms (such as pain, infection, or loosening of the teeth), but sometimes there are no symptoms until a person notices exposed bone.
This problem is most common when bisphosphonates are given by IV (but is still possible when these medications are taken orally). It seems that people who have dental procedures (such as a tooth extraction) are also at higher risk. Be sure to take good care of your mouth and teeth by seeing your dentist frequently. Let your healthcare provider know right away if you think you may have osteonecrosis of the jaw.
  • In rare cases, bisphosphonates (including ibandronate) can cause extreme muscle or bone pain. This usually goes away once the medication is stopped.
     
  • Ibandronate can potentially interact with a number of medications (see Drug Interactions With Ibandronate).
     
  • Ibandronate is considered a pregnancy Category C medication. This means that it may not be safe for use during pregnancy (see Boniva and Pregnancy).
     
  • It is not known whether ibandronate passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Boniva and Breastfeeding).
     
(Precautions and Warnings With Ibandronate Continued: Page 2)
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Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD;