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ibandronate

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Brand names: Boniva

Bisphosphonate Rx

Ibandronate (Boniva) is a medicine that helps treat and prevent bone loss in women after menopause. It makes bones stronger and less likely to break.

Drug Pricing (NADAC)

Generic Price

$52.88/unit

Generic Available

Yes (9 manufacturers)

Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →

What it does

Ibandronate is used to treat and prevent osteoporosis in women after menopause.

Common side effects

Back pain, Upset stomach, Pain in arms or legs

Key warnings

This medicine can cause problems with your esophagus.

How It Works

Ibandronate belongs to a class of drugs called bisphosphonates. It works by slowing down the breakdown of bone. This helps to increase bone density and reduce the risk of fractures.

How to Take It

Take one 150 mg tablet once a month, on the same day each month. Swallow the tablet whole with 6 to 8 ounces of plain water. Do this at least 60 minutes before you eat, drink, or take any other medicines. Do not lie down for at least 60 minutes after taking the tablet.

Pregnancy & Breastfeeding

Ibandronate is not for use in women who can get pregnant. It is not known if this medicine will harm an unborn baby. Talk to your doctor if you are breastfeeding.

Missed Dose

If you miss your monthly dose, take it the next morning if your next dose is more than 7 days away. If your next dose is 1 to 7 days away, wait and take it on your next scheduled day.

Storage

Store at room temperature, away from heat and moisture.

Side Effects (from patient reports)

Based on 1,939 FDA adverse event reports.

Joint pain
243
Diarrhea
230
Feeling sick to your stomach
219
Broken thigh bone
216
Headache
198
Tiredness
190
Falling down
165
Feeling dizzy
163
Pain
161
Weakness
154

FDA Adverse Event Report Analysis

Detailed analysis of 2,935 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2004–2025.

Total Reports

2,935

Death-Related Reports

274

Hospitalization Reports

655

Top Indication

Product Used For Unknown Indication

Gender Distribution

Female 2,324 (89%)
Male 285 (11%)

Age Distribution

0–17 11
18–44 41
45–64 498
65–74 525
75+ 412

Most Reported Adverse Reactions (FAERS)

# Reaction Reports
1 ARTHRALGIA 243
2 DIARRHOEA 230
3 NAUSEA 219
4 FEMUR FRACTURE 216
5 HEADACHE 198
6 FATIGUE 190
7 FALL 165
8 DIZZINESS 163
9 PAIN 161
10 ASTHENIA 154
11 DRUG INEFFECTIVE 140
12 MYALGIA 140
13 PAIN IN EXTREMITY 139
14 VOMITING 138
15 BACK PAIN 132

Reactions in Death Reports

DEATH 125
DIARRHOEA 70
FALL 68
ASCITES 66
AMAUROSIS FUGAX 63
CARDIO-RESPIRATORY ARREST 63
DYSPNOEA 63
EYE PAIN 63
ALTERED STATE OF CONSCIOUSNESS 62
BLINDNESS 62

Reactions in Hospitalization Reports

FEMUR FRACTURE 81
FALL 61
VOMITING 42
PYREXIA 41
DIARRHOEA 40
PNEUMONIA 38
NAUSEA 34
URINARY TRACT INFECTION 34
ASTHENIA 33
ANAEMIA 30

Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation

Serious Warnings

This medicine can cause problems with your esophagus. To help prevent this, follow the directions carefully and stay upright for at least 60 minutes after taking it. Rarely, serious bone, joint, or muscle pain can occur. Tell your doctor if you have new pain in your thigh or groin. Osteonecrosis of the jaw (bone damage in the jaw) has been reported.

Known Drug Interactions

major aspirin

Do not take within 60 minutes of dosing ( 7.1 ) Use caution when co-prescribing aspirin/nonsteroidal anti-inflammatory drugs that may worsen gastrointestinal irritation. 7.2 Aspirin/Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) Because aspirin, NSAIDs, and bisphosphonates are all associated with gastrointestinal irritation, caution should be exercised in the concomitant use of aspirin or NSAIDs with ibandronate sodium tablets.

Mechanism: Both of these medicines can irritate your stomach and throat, which increases the chance of developing sores or pain.

What to do: Be very careful when taking these together and wait at least 60 minutes after taking ibandronate before taking aspirin.

7.3 H2 Blockers In healthy volunteers, co-administration with ranitidine resulted in a 20% increased bioavailability of ibandronate, which was not considered to be clinically relevant (see CLINICAL PHARMACOLOGY [12.3] ) . 7.3 H2 Blockers In healthy volunteers, co-administration with ranitidine resulted in a 20% increased bioavailability of ibandronate, which was not considered to be clinically relevant (see CLINICAL PHARMACOLOGY [12.3] ) .

Mechanism: Ranitidine increases the amount of ibandronate that is absorbed into your body.

What to do: No specific changes are usually needed because this increase is not expected to cause problems.

Common Questions

Can I take ibandronate with food?
No. Take ibandronate at least 60 minutes before your first food or drink of the day.
What should I do if I have heartburn after taking ibandronate?
Stop taking ibandronate and contact your doctor if you develop new or worsening heartburn.
Can I take calcium supplements with ibandronate?
No. Take calcium supplements at a different time of day, at least 60 minutes after taking ibandronate.
What if I can't stand or sit upright for 60 minutes?
You should not take ibandronate if you cannot stand or sit upright for at least 60 minutes.
Does ibandronate interact with other medications?
Yes. Some medicines, like antacids, can interfere with ibandronate. Talk to your doctor about all the medicines you take.
How long should I take ibandronate?
Your doctor will decide how long you should take ibandronate. If you are at low risk for fracture, your doctor may consider stopping the drug after 3 to 5 years.
What are the symptoms of osteonecrosis of the jaw?
Symptoms can include jaw pain, swelling, numbness, or loose teeth.
What should I do if I experience severe bone, joint, or muscle pain?
Contact your doctor if you experience severe bone, joint, or muscle pain.
Can ibandronate cause kidney problems?
Ibandronate is not recommended for patients with severe kidney problems.
What if I have trouble swallowing the tablet?
Swallow the tablet whole with a full glass of water. Do not chew or suck on the tablet.
What are the common side effects of ibandronate?
The most commonly reported side effects of ibandronate include Back pain, Upset stomach, Pain in arms or legs, Diarrhea, Headache. Based on 1,939 FDA adverse event reports. Always consult your healthcare provider about potential side effects.
Does ibandronate interact with other medications?
Yes, ibandronate has 2 known drug interactions. Notable interactions include aspirin, ranitidine. Always inform your doctor about all medications you are taking.
What drug class is ibandronate?
ibandronate belongs to the Bisphosphonate drug class. It requires a prescription (Rx). Ibandronate is used to treat and prevent osteoporosis in women after menopause.
Is ibandronate safe during pregnancy?
Ibandronate is not for use in women who can get pregnant. It is not known if this medicine will harm an unborn baby. Always consult your healthcare provider before using any medication during pregnancy or breastfeeding.

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What the FDA Data Shows for ibandronate

The FDA label for ibandronate (sold under brand names such as Boniva) classifies it as a prescription-only medication in the Bisphosphonate class. Ibandronate is used to treat and prevent osteoporosis in women after menopause. Official labeling lists 6 commonly reported side effects, including Back pain, Upset stomach, Pain in arms or legs.

Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 1,939 voluntary reports. The database also lists 2 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated major severity. NADAC pricing from CMS shows a generic unit cost of $52.88.

Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.

Data Sources

Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).

FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.

Last updated: June 12, 2025

All federal data sources used on this page