Ibandronate, Oral/Injection

What are other names for this medicine?

Type of medicine: bisphosphonate (reduces bone loss)

Generic and brand names: ibandronate, oral; ibandronate, injection; Boniva

What is this medicine used for?

This medicine is used to prevent or treat osteoporosis (bone loss) in men and postmenopausal women (those who have stopped having monthly periods).

It is also used to prevent or treat bone loss in people receiving corticosteroid medicines (such as prednisone).

It may be used for other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine
• cancer such as leukemia or lymphoma
• hypocalcemia (below-normal calcium levels in your blood)
• kidney disease
• problems or pain when swallowing
• ulcers or diseases of the stomach or esophagus.

Tell your healthcare provider if you are not able to sit or stand upright for at least 60 minutes after taking the oral form of this medicine.

Tell your provider the date of your last dental exam and if you are scheduled for dental surgery. You may be at risk of a disease called osteonecrosis of the jaw if you have dental surgery while taking this medicine.

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I take it?

Check the label on the medicine for directions about your specific dose. Take this medicine exactly as your healthcare provider prescribes. Do not take more or less or take it longer than prescribed.

Take the medicine in the morning, before the first food, beverage, or medicines of the day. Do not take this medicine with, or soon after you take other medicines eat, or drink beverages other than water. It will make this medicine less effective.

Take it with a full glass (8 ounces) of plain water (not mineral water, coffee, tea, or orange juice) while you are standing or sitting upright. If you have the tablet, swallow it whole. Do not break, chew, or let the tablet dissolve in your mouth.

Do not take this medicine at bedtime. Do not lie down for at least 60 minutes after taking this medicine. This will keep it from irritating your mouth and throat.

Take calcium and vitamin D supplements, antacids, or any other medicine at least 60 minutes after this medicine. The injection (shot into a vein) form of this medicine is given by your healthcare provider every 3 months.

What if I miss a dose?

If you use the daily tablets and miss a once-daily morning dose, do not take it later in the day. Skip the missed dose and take the next scheduled dose as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

If you use the monthly tablets and miss a dose, take the tablet in the morning after the day you remember if your next monthly dose is more than 7 days away. Do not take 2 doses within 7 days of each other. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: nausea, heartburn, stomach pain, diarrhea, muscle cramps, numbness, tingling, seizures, irritability, unusual thoughts or behavior, coughing blood, black tarry stools.

What should I watch out for?

You may need a bone density test before you start taking this medicine. Your healthcare provider may want to test you again after 6 to 12 months to see how this medicine affects you. Keep all appointments for these tests.

This medicine may increase severe muscle, joint, or bone pain or may cause pain to occur more often. The increased pain may be temporary and may stop during treatment. If the pain continues or gets worse, contact your healthcare provider.

If you are receiving the injection form of this medicine, you may need blood tests regularly to see how this medicine affects your kidneys.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are taking this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (report these to your healthcare provider right away): Difficulty or pain on swallowing, severe heartburn, bloody vomit, black or bloody bowel movements, eye pain, stomach pain, severe bone, joint, or muscle pain.

Other: Dizziness, diarrhea, gas, headache, upset stomach, muscle pain.

What products might interact with this medicine?

Wait at least 30 to 60 minutes after taking this medicine before eating or drinking. ALL foods and drinks can make this medicine less effective.

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, and natural remedies may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• antacids that contain aluminum or magnesium such as Maalox or Mylanta or magnesium supplements (take at least 2 hours after taking this medicine)
• aspirin or other salicylates (take at least 2 hours after taking this medicine)
• calcium supplements and vitamin D (take them at least 2 hours after taking this medicine)
• iron supplements and iron-containing products (take them at least 2 hours after taking this medicine)
• nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Advil, Nuprin), naproxen (Naprosyn, Aleve), ketoprofen, indomethacin (Indocin), nabumetone (Relafen), and sulindac (Clinoril)
• phosphate supplements

Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.