Formulary
Ibandronic acid: Indications, Dosing, Side Effects and Interactions
Bisphosphonates are adsorbed onto hydroxyapatite crystals in bone, slowing both their rate of growth and dissolution, and therefore reducing the rate of bone...
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Ibandronic acid: Indications, Dosing, Side Effects and Interactions
Bisphosphonates are adsorbed onto hydroxyapatite crystals in bone, slowing both their rate of growth and dissolution, and therefore reducing the rate of bone...
Drug action
Bisphosphonates are adsorbed onto hydroxyapatite crystals in bone, slowing both their rate of growth and dissolution, and therefore reducing the rate of bone turnover.
Indications and dose
**Hypercalcaemia of malignancy**
- **Adult** (By Intravenous Infusion): 2-4 mg as a single infusion, dose to be adjusted according to serum calcium concentration.
Cautions
Cautions, further information Elderly With oral use: Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) criteria to aid medication reviews (see Prescribing in the elderly for information): potentially inappropriate in patients with a current or recent history of upper gastro-intestinal disease or bleeding (risk of relapse/exacerbation of oesophagitis, oesophageal ulcer, or oesophageal stricture). Cautions For ibandronic acid General cautions: Atypical femoral fractures Specific cautions: With intravenous use Cardiac disease (avoid fluid overload) With oral use Upper gastro-intestinal disorders
Contraindications
General contra-indications: Hypocalcaemia Specific contra-indications: With oral use Abnormalities of the oesophagus; other factors which delay emptying (e.g. stricture or achalasia)
Side effects
Common or very common Alopecia; anaemia; appetite decreased; arthralgia; asthenia; chills; constipation; diarrhoea; dizziness; dysphagia; electrolyte imbalance; eye inflammation; fever; gastritis; gastrointestinal discomfort; headache; influenza like illness; malaise; myalgia; nausea; oesophageal ulcer (discontinue); oesophagitis (discontinue); pain; peripheral oedema; renal impairment; skin reactions; taste altered; vomiting Uncommon Anaphylactic reaction; angioedema; bronchospasm; oesophageal stenosis (discontinue); osteonecrosis Rare or very rare Atypical femur fracture; Stevens-Johnson syndrome Side-effects For ibandronic acid General side-effects: Common or very common Acute phase reaction Uncommon Asthma exacerbated Rare or very rare Face oedema Specific side-effects: Common or very common With intravenous use Bundle branch block; cataract; increased risk of infection; joint disorder; oral disorders; osteoarthritis; parathyroid disorder; thirst With oral use Gastrointestinal disorders; muscle cramps; musculoskeletal stiffness Uncommon With intravenous use Acrochordon; affective disorder; altered smell sensation; anxiety; blood disorder; cardiovascular disorder; cerebrovascular disorder; cholelithiasis; cystitis; deafness; hyperaesthesia; hypothermia; injury; memory loss; migraine; muscle tone increased; myocardial ischaemia; palpitations; pelvic pain; pulmonary oedema; radiculopathy; renal cyst; sleep disorder; stridor; thrombophlebitis; urinary retention; weight decreased Rare or very rare With intravenous use Anaphylactic shock Frequency not known With oral use Oesophagitis erosive (discontinue)
Interactions
**Other interactions (1):**
- H2 blockers or proton pump inhibitors Of over 1500 patients enrolled in study BM 16549 comparing monthly with daily dosing regimens of ibandronic acid, 14 % and 18 % of patients used histamine (H2)...
Pregnancy
Avoid.
Breast feeding
Avoid-present in milk in animal studies.
Renal impairment
When used for postmenopausal osteoporosis, avoid if creatinine clearance less than 30 mL/minute. M Dose adjustments See Prescribing in renal impairment . With intravenous use: When used for bone metastases, if creatinine clearance 30-49 mL/minute reduce dose to 4 mg; if creatinine clearance less than 30 mL/minute reduce dose to 2 mg. Dilute requisite dose in 500 mL infusion fluid and give over 1 hour. M With oral use: When used for bone metastases, if creatinine clearance 30-49 mL/minute reduce dose to 50 mg on alternative days; if creatinine clearance less than 30 mL/minute reduce dose to 50 mg once weekly. M
Medicinal forms
Tablet,Solution,Solution
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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