From the Guidelines
Ibandronate sodium is recommended for the treatment of osteoporosis in postmenopausal women to reduce the risk of vertebral fractures, as supported by high-quality evidence 1. The medication is a bisphosphonate that works by slowing bone loss and increasing bone mass, which helps reduce the risk of fractures.
- The medication is available in two forms: a 150 mg tablet taken once monthly or as an intravenous injection (3 mg) administered once every three months.
- When taking the oral form, patients should take it first thing in the morning with a full glass of plain water, at least 60 minutes before consuming any food, beverages, or other medications.
- Patients must remain upright (sitting or standing) for at least 60 minutes after taking the tablet to prevent esophageal irritation.
- Common side effects include back pain, heartburn, stomach pain, and nausea.
- Ibandronate works by binding to bone mineral and inhibiting osteoclast activity, the cells responsible for breaking down bone tissue, effectively reducing bone turnover and helping maintain bone density.
- According to the most recent guideline, bisphosphonates, including ibandronate, are recommended as the initial pharmacologic treatment to reduce the risk of fractures in postmenopausal females diagnosed with primary osteoporosis, based on high-certainty evidence 1.
- Patients with severe kidney problems, low blood calcium levels, or difficulty swallowing should avoid this medication, and dental work should ideally be completed before starting treatment due to a rare risk of osteonecrosis of the jaw.
From the FDA Drug Label
Ibandronate Sodium Injection is a bisphosphonate indicated for the treatment of osteoporosis in postmenopausal women. Limitations of Use Optimal duration of use has not been determined. For patients at low-risk for fracture, consider drug discontinuation after 3 to 5 years of use
The indication for ibandronate sodium is the treatment of osteoporosis in postmenopausal women 2, 3, 3.
- The optimal duration of use has not been determined, but for patients at low-risk for fracture, consider drug discontinuation after 3 to 5 years of use.
- Key warnings include hypocalcemia, hypersensitivity, and renal toxicity 3.
From the Research
Ibandronate Sodium Overview
- Ibandronate sodium, also known as ibandronic acid, is a nitrogen-containing bisphosphonate used in the treatment and prevention of postmenopausal osteoporosis 4, 5, 6.
- It is available in once-monthly oral and quarterly intravenous formulations for intermittent administration 4.
Efficacy and Tolerability
- Ibandronate has been shown to be effective in reducing the incidence of vertebral fractures, with relative risk reductions of 62% and 50% for daily and intermittent ibandronate, respectively 5.
- The once-monthly oral formulation has been evaluated in clinical trials, demonstrating a significantly greater increase in lumbar spine bone mineral density (BMD) compared to daily ibandronate 5.
- Intravenous ibandronate has also been shown to be effective in increasing lumbar spine BMD and reducing biochemical markers of bone turnover 6.
- Ibandronate is generally well tolerated, with a similar adverse-event profile to other bisphosphonates 5, 6.
Comparison to Other Treatments
- Once-monthly ibandronate has been compared to weekly alendronate in the MOTION study, demonstrating non-inferiority in terms of increasing lumbar spine and total hip BMD 7.
- A meta-analysis has compared the time course of BMD changes with denosumab, bisphosphonates, and other drugs, showing that denosumab resulted in larger changes in LS and TH BMD compared to 3 years of treatment with ibandronate and other bisphosphonates 8.