Ibandronic Acid

Indications
 Oral
Prophylaxis of skeletal events in patients with breast cancer and bone metastases
Adult: As ibandronic acid: 50 mg daily.
Oral
Postmenopausal osteoporosis
Adult: As ibandronic acid: 150 mg once mthly on the same date each mth or 2.5 mg daily. Missed once-mthly dose: If next scheduled dose is >7 days away: Take dose the next morning and return to original schedule; if next dose is <7 days away: Wait until the next scheduled dose; 2 tabs must not be taken within the same wk.
Oral
Prophylaxis of postmenopausal osteoporosis
Adult: As ibandronic acid: 150 mg once mthly on the same date each mth or 2.5 mg daily. Missed once-mthly dose: If next scheduled dose is >7 days away: Take dose the next morning and return to original schedule; if next dose is <7 days away: Wait until the next scheduled dose; 2 tabs must not be taken within the same wk.
Intravenous
Hypercalcaemia of malignancy
Adult: As ibandronic acid: 2-4 mg as a single dose infused over 2 hr. Max: 6 mg/dose.
Max Dosage: 6 mg.
Intravenous
Postmenopausal osteoporosis
Adult: As ibandronic acid: 3 mg once every 3 mth; inj given over 15-30 sec. Missed dose: Give inj as soon as possible; then reschedule next inj 3 mth from this inj, as it should not be given more frequently than once every 3 mth.
Intravenous
Prophylaxis of postmenopausal osteoporosis
Adult: As ibandronic acid: 3 mg once every 3 mth; inj given over 15-30 sec. Missed dose: Give inj as soon as possible; then reschedule next inj 3 mth from this inj, as it should not be given more frequently than once every 3 mth.
Intravenous
Prophylaxis of skeletal events in patients with breast cancer and bone metastases
Adult: As ibandronic acid: 6 mg infused over at least 15 minutes. Repeat dose every 3-4 wk.
Contraindications
 Severe renal impairment, uncorrected hypocalcaemia, acute upper GI inflammation, inability to stand or sit upright for at least 60 min (oral).
Warnings / Precautions
 History of bone/joint/muscle pain; dysphagia, oesophageal disease, gastritis, duodenitis, ulcers. Risk factors for osteonecrosis of the jaw. Pregnancy and lactation.
Adverse Reactions
 Fever; influenza-like syndrome; electrolyte disturbances; GI disturbances; musculoskeletal pain; headache; rash, allergic dermatitis; anaemia; decreased alkaline phosphatase; hypercholesterolaemia; UTI; local reactions (parenteral); renal impairment (parenteral).
Overdose Reactions
 Symptoms: Dyspepsia, oesophagitis, gastritis, ulcer, electrolyte disturbances. Management: Use milk or antacids to bind ibandronate. Do not induce vomiting. Dialysis may be beneficial if administered within 2 hr of IV formulation overdose.
Drug Interactions
 Impaired absorption with aluminium, calcium, iron, magnesium compounds. Increased risk of GI or renal adverse effects with NSAIDs. Additive hypocalcaemic effects with aminoglycosides.
See Below for More ibandronic acid Drug Interactions
Lab Interactions
 May interfere with diagnostic imaging agents e.g. technetium-99m-diphosphonate in bone scans.
Food Interactions
 Impaired absorption.
Mechanism of Actions
 Ibandronic acid is a potent bone resorption inhibitor, which acts on osteoclasts or on osteoclast precursors. It increases bone mineral density by reducing the rate of bone resorption.
Absorption: Poorly absorbed orally. Absolute bioavailability: <1%.
Distribution: Protein-binding: 85-99%.
Excretion: Via urine. Unabsorbed drug via faeces.
Administration
 Should be taken on an empty stomach. (Must be taken at least 1 hr before the 1st food, drink or medication of the day. Take w/ a full glass of only plain water upon arising for the day & remain in sitting/upright position for at least 1 hr. Do not lie down, eat/drink anything except plain water or take other oral medicines for at least 1 hr. Swallow whole, do not chew/crush/suck.)
Storage Conditions
 Intravenous: Store at controlled room temperature of 15-30°C (59-86°F). Oral: Store at controlled room temperature of 15-30°C (59-86°F).
ATC Classification
 M05BA06 - ibandronic acid ; Belongs to the class of bisphosphonates. Used in the treatment of bone diseases.
Storage
 Intravenous: Store at controlled room temperature of 15-30°C (59-86°F). Oral: Store at controlled room temperature of 15-30°C (59-86°F).
Available As
  • Ibandronic Acid 1 mg
  • Ibandronic Acid 150 mg
  • Ibandronate 150 mg
  • Ibandronic Acid 50 mg
  • Ibandronate 50 mg
  • Ibandronic Acid 6 mg

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