Ibandronate

How it works

It binds to bone mineral and inhibits osteoclast-mediated bone resorption, increasing bone mineral density over time.

Prescribing in practice

• Oral doses must be taken with the patient sitting or standing and remaining upright, on an empty stomach with plain water and nothing else for the period specified in the SPC, to reduce oesophageal irritation and aid absorption.
• Assess and correct hypocalcaemia and vitamin D deficiency before starting, and counsel on the rare risks of osteonecrosis of the jaw and atypical femoral fractures.
• Use with caution in renal impairment and ensure dental health is reviewed before treatment where indicated.

Monitoring

Monitor renal function and calcium status, and review the need for continued therapy periodically in line with current guidance.

Counselling the patient

• Take oral tablets exactly as instructed: upright, on an empty stomach with plain water, and do not lie down afterwards.
• Report new thigh, hip or groin pain, or any dental problems or jaw pain.
• Maintain good dental hygiene and tell your dentist you take this medicine.

Evidence & guidelines

Bisphosphonates reduce fragility fracture risk in osteoporosis, and MHRA advice highlights atypical femoral fracture and osteonecrosis of the jaw as recognised risks.