Bisphosphonate

Ibandronic acid

Brand names: Bonviva, Bondronat

Adult dose

Dose: Osteoporosis: 150mg PO monthly OR 3mg IV every 3 months. Bone metastases / hypercalcaemia: per BNF (specialist)

Route: PO/IV

Frequency: monthly or q3m

Dose adjustments

Renal

Avoid if eGFR <30 (osteoporosis); reduce in oncology indications

Clinical pearls

PO: take 60 min before food/drink with plain water, remain upright
Dental review before starting

Contraindications

Severe renal impairment
Hypocalcaemia
Inability to sit/stand upright for 60 min (PO)
Oesophageal stricture/achalasia (PO)

Side effects

Oesophagitis (PO)
Hypocalcaemia
Acute-phase reaction (IV)
Osteonecrosis of jaw
Atypical femoral fracture
Renal impairment

Interactions

Calcium/iron/antacids reduce PO absorption (separate by 60 min)
NSAIDs (renal)

Monitoring

Calcium
U&E
Vitamin D

Reference: BNF; NICE TA464; https://bnf.nice.org.uk/drugs/ibandronic-acid/. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Pathways