by Melody St. John

Created on: April 20, 2009   Last Updated: July 30, 2011

Ibandronate sodium is a new drug that's marketed under the brand name Boniva.

This drug belongs to the bisphosphonate class, a group of drugs that delay or stop the natural process of bone tissue dissolution or resorption, leading to the maintenance or increase in bone density and strength.

Why it is prescribed

As a bisphosphonate, ibandronate sodium (Boniva) is prescribed for the prevention or treatment of osteoporosis in postmenopausal women. This drug is usually given to prevent bone loss due to osteoporosis; or when this condition has already developed, ibandronate sodium is taken to slow the rate of bone thinning, thus lowering the risk of fractures.

Unlabeled uses of this drug include treatment of metastatic bone disease in breast cancer.

How the drug works

Ibandronate sodium's effect on bone tissue is related to its affinity for hydroxyapatite, a component of the bone matrix. This drug inhibits certain cells called osteoclasts from breaking down and nibbling at bone tissues, thus preventing bone resorption and turnover. In postmenopausal women, ibandronate sodium decreases the rate of bone turnover, which can then result in a net increase in bone mass.

Available drug forms

Ibandronate sodium comes in 2.5 mg and 150 mg tablets. It is also available in 1 mg/ml injections.

When it is contraindicated

This drug is contraindicated in:

Patients who cannot sit or stand erect for at least 60 minutes (tablets);
Patients with untreated hypocalcemia, or low blood calcium level (injections, tablets);
Allergic reaction to any ingredient of the drug (injections, tablets)
Absorption, distribution, metabolism and elimination

Ibandronate sodium is absorbed in the upper portion of the gastrointestinal tract. Unabsorbed drug is excreted unchanged in the feces while the absorbed ibandronate goes to the bone tissues and binds with the bone matrix to exert its therapeutic effect.

This drug is not metabolized in the liver and does not inhibit the activity of cytochrome P450 system, a group of enzymes responsible for catalyzing various key biochemical reactions in the body. Ibandronate that is not taken from the circulation through bone resorption is excreted unchanged by the kidney through the urine.

Special considerations

When taking ibandronate sodium, you need to consider the following:

Tablets come in two strengths (2.5 mg for once-a-day dosing, and 150 mg for once-a-month dosing). So be sure to check the label carefully to avoid confusion.

Take ibandronate tablets with plain

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