BONIVA (ibandronate sodium)

What is it: Selective Bisphosphonate. It alters the cycle of bone formation and breakdown in the body. Ibandronate slows bone loss while increasing bone mass, which may prevent bone fractures.

Use: Raloxifene is used to help prevent and treat thinning of the bones (osteoporosis) only in postmenopausal women. It works like an estrogen to stop the bone loss that can develop in women after menopause, but it does not increase the bone density as much as daily 0.625 mg doses of conjugated estrogens. Raloxifene will not treat hot flashes of menopause and may cause hot flashes to occur. In addition, raloxifene does not stimulate the breast or uterus as estrogen does.

Side Effects: Common: Constipation; diarrhea; dizziness; headache; heartburn; mild flu-like symptoms; nausea; pain in the arms, legs, or back; stomach upset; vomiting.

Ibandronate sodium may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Boniva with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it. Seek medical attention right away if any of these SEVERE side effects occur: severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bloody or black, tarry stools;chest pain; eye pain; painful or difficult swallowing; severe bone, joint, or muscle pain; severe or persistent dizziness or headache; severe or persistent heartburn or stomach pain; swelling or pain in your jaw; vision changes; vomiting blood or a substance that looks like coffee grounds.

Precautions: It is very important that you keep your appointments with your doctor even if you feel well. Before you have any kind of surgery, tell the medical doctor in charge that you are using this medicine. Discuss discontinuing use of raloxifene 3 days before you think you will have a long period of inactivity, sitting, or bed rest, such as after having surgery or going on a long trip. If you are going on a trip and stay on raloxifene, you should walk regularly or move about when possible. Remaining still for long periods may cause blood clots for some people, and raloxifene may rarely worsen their condition. Stop using the medicine immediately if you think you have become pregnant and check with your doctor. Raloxifene does not act like an estrogen to stimulate the uterus or breast. If you experience vaginal bleeding, breast pain or enlargement, or swelling of hands or feet while on raloxifene, you should report it to your doctor.

Directions: Take ibandronate sodium by mouth on an empty stomach at least 1 hour before eating. Ibandronate sodium is only effective when taken on an empty stomach. Take Boniva with 6 to 8 ounces (180 to 250 mL) of plain water (not mineral water) first thing in the morning at least 60 minutes before you take any other medicines or drink anything other than plain water. Swallow ibandronate sodium whole. Do not break, crush, or chew before swallowing. DO NOT lie down for 60 minutes after taking ibandronate sodium.

Calcium or iron supplements, vitamins, or antacids containing calcium, magnesium, aluminum, or iron may interfere with the absorption of ibandronate sodium . Take these products and any other medicines at least 1 hour after taking ibandronate sodium.

Missed Doses: If you miss a dose of ibandronate sodium and your next scheduled dose is more than 7 days away, take one dose in the morning on the day after you remember. Then return to your original schedule. Do not take 2 doses within the same week. If your next scheduled dose is 1 to 7 days away, skip the missed dose and go back to your regular dosing schedule. If you miss a dose of ibandronate sodium and you are unsure of what to do, contact your doctor.

Storage: Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing. Keep out of the reach of children. Do not keep outdated medicine or medicine no longer needed.