Top 300 Pharmacy Drug Cards

IBANDRONATE: Boniva, Various

Class: Bisphosphonate

Dosage Forms. Tablet: 150 mg

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Common FDA Label Indication, Dosing, and Titration.

1. Postmenopausal osteoporosis: 150 mg po once monthly

2. Postmenopausal osteoporosis: Prophylaxis: 150 mg po once monthly

Off-Label Uses. None

MOA. Ibandronate binds to bone hydroxyapatite and, at the cellular level, inhibits osteoclast activity, thereby modulating bone metabolism.

Drug Characteristics: Ibandronate

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Medication Safety Issues: Ibandronate

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Drug Interactions: Ibandronate

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Adverse Reactions: Ibandronate

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Efficacy Monitoring Parameters. Increased bone mineral density. Decreased incidence of bone fractures.

Toxicity Monitoring Parameters. Baseline serum creatinine, calcium, phosphorous. Seek medical attention if severe skin rash, difficulty swallowing, swelling, tooth problems, or severe pain.

Key Patient Counseling Points. Take this medicine as soon as you get out of bed in the morning, before you eat or have anything to drink. Swallow the tablet whole with a large glass (8 ounces) of plain water only (not mineral water, coffee, juice, or any other liquid). Do not chew or suck on the tablet. Do not take the medicine while you are still in bed, and do not take it at bedtime. Wait for at least 60 min after you swallow the tablet before you eat or drink anything or take any other medicines. This will help your body absorb the medicine. Do not lie down for at least 60 min after taking this medicine, and do not lie down until after you have eaten some food.

Clinical Pearls. Concurrent chemotherapy and poor oral hygiene increase the risk for osteonecrosis of the jaw. Atypical fractures of the thigh (subtrochanteric and diaphyseal femur fractures) have been reported in patients taking bisphosphonates for osteoporosis; discontinue therapy in patients who develop evidence of a femoral shaft fracture. Given the toxicities, FDA recommends consideration of discontinuation of ibandronate in patients at lower risk of osteoporosis after 3-5 y of therapy. Medication guide required at dispensing.