IbandronateIbandronate Sodium

About Ibandronate

Ibandronate binds to bone and slows the cells that break it down, raising bone density. The tablet is labeled to treat and prevent osteoporosis after menopause, the injection to treat it. In the label’s studies, a daily dose no longer sold reduced new spine fractures but not other fractures, and the monthly tablet was compared with it on bone density. Women at low fracture risk may be considered for stopping after 3 to 5 years.

The tablet is not for anyone who cannot stay upright for 60 minutes, has an esophagus problem that slows emptying, or has low blood calcium. Back pain, indigestion, diarrhea and headache are common; painful swallowing, chest pain or new heartburn mean stopping and seeking advice. The injection, 3 mg into a vein, is given only by a health professional after a kidney blood test; flu-like symptoms can follow it, and serious allergic reactions have been reported. Neither form is used in severe kidney impairment.

Both forms carry the bisphosphonate warnings. Jaw bone damage (osteonecrosis) has been reported, mostly after a tooth extraction or infection, so a dental check before starting is advised. Unusual breaks of the thigh bone can occur with little or no injury, sometimes after weeks of dull, aching thigh or groin pain, which should be reported. There is no boxed warning.

Taking Ibandronate

How to take it

Tablet: once a month on the same date, after getting up and before any food, drink or other medicine. Swallow it whole with 6 to 8 ounces of plain water, not mineral water, sitting or standing; do not chew or suck it. Then wait at least 60 minutes before lying down, eating, drinking anything but water, or taking other medicines, vitamins or antacids.

If you miss a dose

If your next date is more than 7 days away, take one tablet the morning after you remember; if it is 7 days or less, skip it. Then keep to your usual date, and never take two tablets in one week. A missed injection is given as soon as it can be rescheduled, then every three months from that date.

Storage

At room temperature in a tightly closed container, away from heat and moisture, out of reach of children.

Interactions to know about

Calcium, iron, magnesium, antacids and other supplements block absorption, so take them at least 60 minutes after the tablet. Aspirin and anti-inflammatories such as ibuprofen add to stomach irritation. Report jaw pain, loose teeth, or thigh or groin pain.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Ibandronate differs from pharmacy to pharmacy

Generic tablets have several makers, and a month’s supply is one tablet, so the dispensing fee and mark-up are most of a cash quote; a pharmacy with a flat minimum charges about the same for one tablet as for three. The injection’s syringe has few makers, and the visit to give it is charged on top.

Ways to pay less for Ibandronate without insurance

• Ask for a ninety-day supply, three tablets for one dispensing fee.
• Ask whether ibandronate is on the pharmacy’s flat-price generic list.
• For the injection, ask how the syringe and the visit are each charged, and whether the tablet would suit you.
• Ask the prescriber whether alendronate, a weekly bisphosphonate with many generic makers, would suit you.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Ibandronate

1. 1.How long after the tablet must I wait before breakfast, coffee or other medicines?
2. 2.When should I take calcium, vitamin D or antacids?
3. 3.What if I forget my monthly tablet?
4. 4.Should I see a dentist before starting?
5. 5.Which jaw, thigh or groin symptoms should I report?

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