BONIVA (ibandronate sodium) is a nitrogen-containing bisphosphonate that inhibits osteoclast-mediated bone resorption. The chemical name for ibandronate sodium is 3-(N-methyl-N-pentyl)amino-1-hydroxypropane-1,1diphosphonic acid, monosodium salt, monohydrate with the molecular formula C9H22NO7P2Na•H2O and a molecular weight of 359.24. Ibandronate sodium is a white-to off-white powder. It is freely soluble in water and practically insoluble in organic solvents. Ibandronate sodium has the following structural formula:
BONIVA Injection is intended for intravenous administration only. BONIVA Injection is available as a sterile, clear, colorless, ready-to-use solution in a prefilled syringe that delivers 3.375 mg of ibandronate monosodium salt monohydrate in 3 mL of solution, equivalent to a dose of 3 mg ibandronate free acid. Inactive ingredients include sodium chloride, glacial acetic acid, sodium acetate and water.
What are the precautions when taking ibandronate sodium injection (Boniva Injection)?
Before using ibandronate, tell your doctor or pharmacist if you are allergic to it; or to other bisphosphonates (such as alendronate, etidronate, pamidronate, risedronate); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: low blood calcium levels (hypocalcemia), severe kidney disease.
Some people using ibandronate may have serious jawbone problems. Your doctor should check your mouth before you start this medication. Tell your dentist that you are using this medication before you have any dental work done.
Calcium and vitamin D
For ibandronic acid to work well you need to have good levels of vitamin D and calcium in your body. If you cannot take in enough vitamin D and calcium in your diet, your doctor will prescribe vitamin D and calcium supplements for you.
About side effects
We’ve listed the side effects associated with ibandronic acid below. You can use the links to find out more about each side effect. Where there is no link, please go to our cancer drug side effects section or use the search box at the top of the page.
You may have a few side effects. They may be mild or more severe. A side effect may get better or worse through your course of treatment. Or more side effects may develop as the course goes on. This depends on
- How many times you’ve had the drug before
- Your general health
- The amount of the drug you have (the dose)
- How you have the drug (whether by drip or as a tablet)
The side effects may be different if you are having ibandronic acid with other drugs.
Common side effects
More than 10 in every 100 people have one or more of these.
- A high temperature (fever)
- Low levels of calcium in your blood (hypocalcaemia) – you will have blood tests to check the levels of calcium and other minerals such as potassium, phosphate and magnesium. Usually, the blood test picks up any imbalance before you have any symptoms. A low calcium level can cause changes in sensation so you may have tingling or burning in your lips and tongue
- Irritation of the food pipe (oesophagus) can be a side effect of taking ibandronic acid tablets – tell your doctor if you already have a condition of your oesophagus or if you develop pain or difficulty swallowing
- Lowered sensitivity of the skin
- Headaches or dizziness
- Bone pain when you first start treatment – you may need stronger painkillers until the pain improves