The action of ibandronate on bone tissue is based on its affinity for hydroxyapatite, which is part of the mineral matrix of bone. Ibandronate inhibits osteoclast activity and reduces bone resorption and turnover. In postmenopausal women, it reduces the elevated rate of bone turnover, leading to, on average, a net gain in bone mass.

BONIVA is a bisphosphonate indicated for the treatment and prevention of postmenopausal osteoporosis. 

One 150 mg tablet taken once monthly or one 2.5 mg tablet taken once daily.

Dosing instructions.

• Swallow whole tablet with 6-8 oz of plain water only, at least 60 minutes before the first food, beverage, or medication of the day.
• Do not lie down for at least 60 minutes after taking BONIVA.
• Do not eat, drink (except for water), or take other medication for 60 minutes after taking BONIVA.

The most common adverse reactions (>5%) are back pain, dyspepsia, pain in extremity, diarrhea, headache, and myalgia

• Abnormalities of the esophagus which delay esophageal emptying such as stricture or achalasia
• Inability to stand or sit upright for at least 60 minutes
• Hypocalcemia
• Hypersensitivity to BONIV

• Severe irritation of the upper gastrointestinal (GI) mucosa can occur. Dosing instructions should be followed and caution should be used in patients with active upper GI disease. Discontinue use if new or worsening symptoms occur.
• Hypocalcemia may worsen during treatment. Correct hypocalcemia before use.
• Severe bone, joint, and muscle pain may occur. Consider discontinuing use if symptoms develop.
• Osteonecrosis of the jaw has been reported.