Summary: Today’s episode was sponsored by Lexi-Comp. To access the same great drug information that was used in today’s podcast or for a chance to win an iPod touch and free Lexi-Comp software, please visit www.lexi.com/top200 (http://thestudentpharmacist.com/www.lexi.com/top200). And, as a special offer to all top200 listeners, use promotion code TOP200 to save 20% on your software purchase today! 172 Boniva® (ibandronate) (http://thestudentpharmacist.com/wp-content/uploads/172_Boniva.mp3) Episode Notes (References Below) * Brand/Generic: * Generic: ibandronate (not available) * Brand: Boniva® * Mechanism of Action * Bisphosphonate * Inhibits osteoclasts, which decreases bone turnover and resorption * This indirectly increases bone mineral density * Indication(s) * Osteoporosis in postmenopausal females * Treatment and prevention * Dosage form(s) * Injection solution: 1 mg/mL (3 mg vial) * Tablets: * Once daily formulation: 2.5 mg * Once-monthly formulation: 150 mg * Adult Dosing * Oral tablets: 2.5 mg once daily or 150 mg once monthly * Treatment or prevention * IV: 3 mg every 3 months * Treatment dose * Notes: * If diet is inadequate, patients should be on supplemental calcium and vitamin D while on bisphosphonates * Vitamin D: 800-1000 Units/day * Calcium: 1200-1500 mg/day * No dosing adjustment is needed in hepatic impairment * Use is not recommended in severe renal impairment: (CrCl 10% * Dyspepsia * Back pain * 1-10% * Hypertension * Headache * Dizziness * Insomnia * GI upset * MAJOR Drug Interactions * No oral drugs should be taken within 60 minutes of Boniva® (ibandronate) * NSAIDs can increase the risk of GI irritation * Pregnancy Category/Breast feeding * Category C * Excretion in breast milk is unknown (use with caution) * Safety and Efficacy Monitoring * Central bone mineral density scan at baseline then 1-2 years after initiation * Serum Calcium and Vitamin D * Blood pressure * Major Counseling Points * Take each dose first thing in the morning with a full glass of water * Remain upright (sitting or standing) for at least 60 minutes after taking and do not take any other oral medications within 60 minutes of taking Boniva® * Patients should avoid alcohol (which can cause or contribute to osteoporosis) * Counsel on main side effects (GI upset, dyspepsia, headache, insomnia, and back pain) * As always, patients should report any persistent, severe, or intolerable side effects to their doctor or pharmacist References: * Ibandronate. In: Lexi-Comp Online [Internet]. Hudson, OH: Lexi-Comp, Inc. [updated 2011, cited 2011 Aug 6]. [about 8 p.]. Available from http://online.lexi.com/crlsql/servlet/crlonline * Boniva®. In: Pharmacy Drug Cards 23rd Edition. SFI Medical Publishing; 2007. Available from: http://www.sfirx.com/view_product.php?id=17
