Ibandronate (Intravenous)

Ibandronate is an intravenous injection given by physicians to treat thinning bones in post-menopausal women, also known as osteoporosis.

Overview

Ibandronate, also known under its marketed name of Boniva, is an injected medication that doctors prescribe for treatment of osteoporosis, when bones become thin after menopause in some women. Women who have osteoporosis are prone to breaking bones in the wrist, spine, hip and other places after they have become fragile. The bones may be so fragile that a sneeze or cough could fracture a rib.

Treatment with Ibandronate and other bisphosphonate drugs increase the amount of bone and also increases the bone strength in persons diagnosed with osteoporosis. These drugs work by stopping the breakdown of bone cells, which naturally occurs in the body as we age and lose minerals such as calcium in our bones. With the use of Ibandronate, the bone cell breakdown is slowed, which increases the strength of the bone cells that are already there and also can increase the amount of bone. Supplemental vitamin D and calcium, as well as dietary changes, will aid in the production of bone cells while Ibandronate prevents their breakdown.

Loss of bone density is a normal part of aging, but some people lose bone density at a more rapid rate than others. Women are at a higher risk of osteoporosis due to menopause, especially if it begins before age 45. Long-term use of some drugs, such as corticosteroids, may also lead to bone density loss. Most patients are not diagnosed until they have already fractured a bone. While Ibandronate is effective in strengthening and increasing bone cells, it is not a cure for osteoporosis.

Conditions Treated

  • Hypercalcemia of malignancy
  • Bone destruction
  • Bone metastases

Type Of Medicine

  • Bisphosphonate

Side Effects

If, after your injection of Ibandronate, you experience the following adverse effects on your health, it is imperative to get in touch with your physician immediately:

  • Blurred vision
  • Back pain
  • Difficulty moving
  • Headache
  • Dizziness
  • Stiff, painful muscles
  • Nervous demeanor
  • Joint pain
  • Pounding ears
  • Rapid or sluggish heart rhythm
  • Pain in bladder
  • Cloudy or bloody urine
  • Pain or aches in the body
  • Coughing with or without mucus
  • Diarrhea
  • Painful, burning or difficult urination
  • Congestion of the ear
  • Elevated body temperature
  • Frequent urination urge
  • Ill, uncomfortable feeling
  • Little to no appetite
  • Vocal changes
  • Pain in side or lower back
  • Pains, cramps or aches in muscles
  • Congested nasal passages
  • Nausea
  • Arm or leg pain
  • Swollen, red, painful joints
  • Shivering
  • Gasping for breath
  • Sneezing
  • Throat soreness
  • Sweating
  • Joints are swollen
  • Chest is tight
  • Insomnia
  • Fatigue
  • Weak muscles
  • Stomach or abdominal cramps
  • Agitated mood
  • Change in vision or decrease
  • Joint, muscle or bone pain
  • Coma
  • Confused demeanor
  • Convulsions
  • Less urine than normal
  • Depression
  • Swallowing difficulty
  • Painful, red or tender eyes
  • Jaw feels heavy
  • Hives on skin
  • Hostile mood
  • Tear production has increased
  • Heart rhythm is irregular
  • Irritable
  • Itching skin
  • Hives or swollen masses on sex organs, lips, face, throat, tongue, eyelids, hands, feet or legs
  • Lethargic demeanor
  • Tooth becomes loose
  • Cramps in feet, hands, legs, face or arms
  • Twitching muscles
  • Tingling, numb fingers, feet or mouth
  • Numb, swollen, painful jaw or mouth
  • Putting on weight quickly
  • Skin rash
  • Seizures
  • Light sensitivity
  • Pain in eyes, severe
  • Stupor
  • Increased tear production
  • Tremors
  • Painful groin, hips or thighs

Other adverse health effects, while annoying, will likely disappear over time with continued use of Ibandronate as your system becomes used to the effect the drug has on you. Report the following symptoms, should you experience them, in case your doctor can advise you on how to alleviate them:

  • Abdominal pain
  • Sour stomach
  • Gas
  • Burning in stomach or chest
  • Constipation
  • Diarrhea
  • Heartburn
  • Indigestion
  • Skin with streaks of red
  • Upset stomach
  • Nasal congestion
  • Tender, swollen, painful injection site
  • Stomach is tender
  • Weak muscles

Any changes to your health, even symptoms that aren't listed here, after being treated with Ibandronate should be reported to your physician right away.

Dosage

Ibandronate will be injected into your veins by a trained medical professional such as a doctor or nurse. You will be in a hospital or clinic and have a dosage injected every three months. Do not miss your scheduled injection appointments; should you have to reschedule, make sure you get in as early as possible.

Your doctor will recommend a diet to you that consists mainly of balanced nutrition and adequate vitamin D and calcium. You may also have to take supplements of vitamin D and calcium, which help improve bone strength while you are being treated with Ibandronate.

After a few injections, your physician will most likely prescribe you an oral medication that works in the same way as Ibandronate going forward instead. Be sure you read and understand the patient information leaflet you are given with your Ibandronate injections as well as any treatment regime information provided to you by your physician.

Most patients are dosed with three milligrams of Ibandronate solution to be injected into a vein every ninety days.

Interactions

Hypersensitive reactions you've had to other medications or to Ibandronate in the past should be reported to your physician prior to receiving treatment of this medication. You should also mention any reactions you've had to foods, perfumes, dyes or preservatives that could also affect your safety with this drug.

Pediatric patients have not been studied in order to provide adequate data on the safety of Ibandronate treatment for this age group, nor is it known if it is effective for bone problems in children. Use in pediatric patients is not recommended.

Geriatric patients have not had any data point to age-related problems that would affect how risky treatment with Ibandronate is or how effective it is. There are no cautions or limitations on use of this medication in this age group.

With regard to women who are pregnant and those that are breastfeeding, it is unknown through study or any concrete data if Ibandronate is safe and effective for these groups. Discuss the use of this medication with your physician if you're pregnant, may become pregnant or are breastfeeding an infant prior to your injected treatment.

Your physician will instruct you on a proper diet and any vitamin supplements that are recommended during your course of treatment. Avoid taking anything other than what your physician has prescribed for you if possible. Other medications that you're on including supplements, herbs and treatments should be disclosed to your physician prior to being treated with Ibandronate. Certain foods may be regulated in their amounts for you, as they could increase the risk of certain adverse effects if consumed in unapproved quantities. Discuss your food intake with special regard to dairy products with your physician.

If you have the following medical conditions, they should be brought up to your doctor prior to your treatment with Ibandronate, as they could worsen with your treatment or cause other risks:

  • Blood diseases including anemia or clotting problems
  • Cancer
  • Dental issues
  • Pending dental procedures
  • Infections
  • Oral hygiene issues
  • Jaw or dental surgery
  • Diabetes
  • Hypertension
  • Heart disease
  • Low calcium levels
  • Low vitamin D levels
  • Severe kidney disease

Warnings

You will be monitored closely by your physician during your treatment with Ibandronate by scheduled regular appointments. Not only will this ensure that the medication is effective on your condition, it will also reassure you that your health is not being affected adversely by taking this drug. Make sure you keep all appointments as scheduled and report any adverse health effects or changes to your mood or demeanor to your doctor right away.

The risk for anaphylaxis is increased with use of Ibandronate on your osteoporosis. If you have difficulty swallowing or breathing, skin rashes or itching or any swelling in your face, mouth or hands after your injection, get in touch with your doctor immediately.

Ibandronate may lower your blood calcium levels and cause you to have spasms, twitching or numb muscles including lips, toes or fingers. Contact your doctor immediately if you have any of these symptoms.

Inform all health care providers that are treating you that you are having Ibandronate injections. This includes any dentists or other physicians or nurses. Ibandronate could give you problems with your teeth or jaw. Report these symptoms to your physician along with any other join, muscle or bone pain. Any bone scans you have during your treatment may be affected by the use of Ibandronate and not give clear results.

Prolonged use of Ibandronate could put you at risk for fractures of your thigh bone. Aches or dull pains in your groin, hips or thighs should be reported to your physician immediately.

Avoid taking vitamin supplements, herbal remedies, holistic treatments and other prescriptions and over-the counter medications during your treatment with Ibandronate unless specifically approved by your physician.

Discuss the use of tobacco products and the consumption of alcoholic beverages with your physician prior to your treatment with Ibandronate, as these substances could have an effect on how this medication works for you or could even increase certain adverse health effects, in some cases.

Storage

Ibandronate will be stored and administered in a hospital or medical clinic setting only, with storage according to the manufacturer's instructions carried out by the medical professional staff.

The manufacturer recommends that the vials of medication be stored in their original packaging under room temperature conditions. Any opened Ibandronate should be used immediately or discarded according to safety instructions and local guidelines.

Summary

Ibandronate is injected to treat bones that have become thin due to a condition called osteoporosis. The biggest risk of developing osteoporosis is in women who are post-menopausal, especially those that have experienced this life change early. Ibandronate is injected into a patient's vein during an appointment with a physician in a clinic or hospital. After a few injections, spaced three months apart, it is likely you will be given oral medication going forward with your treatment.

Regular visits to monitor the progress of the medication against your condition will be scheduled and should be kept to the best of your abilities. During these visits you will also be monitored for any possible adverse effects on your health. Your physician will want you to follow a balanced diet with a certain amount of vitamin D and calcium or supplemented nutritional medications. Follow this diet as much as possible, as the effectiveness of Ibandronate depends on it.

Symptoms including difficulty breathing or swallowing, skin itching or rashes or swollen face, mouth or hands could be signs of a life-threatening condition known as anaphylaxis. Additionally, low blood calcium symptoms such as twitching muscles or numb toes, fingers or lips should be reported to your doctor immediately. Other side effects, while not dangerous, can be annoying and should be reported to your doctor in case they are the sign of long-term health issues or in case they can be eased.

Your treatment of Ibandronate should be disclosed to any other physicians that will be treating you, including those that will be giving you a bone scan. Dental professionals should also be notified, as this medication can cause tooth or jaw problems that require specialized medical treatment.

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