Boniva® is a prescription medicine option for treatment of osteoporosis. Boniva is in the class of medicines called bisphosphonates that also includes Actonel, generic alendronate, Atelvia, Fosamax, and Reclast. Bisphosphonates work by decreasing the rate of bone breakdown.

Generic Version Available

Boniva is often referred to as the “Sally Field drug.” Since Sally Field was a celebrity endorser of this medicine. She was a ubiquitous representative of Boniva in advertisements. Even Saturday Night Live took notice and spoofed her television commercial. In 2011, her endorsement contract ended as Boniva was nearing the end of its patent life. Generic formulations of the tablet Boniva called ibandronate became available in March 2012.

Once Monthly Tablet or Given by Vein 

Boniva is given as a once monthly tablet most commonly. However, it is also available for administration by vein every three months. When taking the tablet once a month, special instructions need to be followed as with the other bisphosphonate tablets. For Boniva, a longer wait time of 60 minutes is necessary before eating, drinking, or taking other medicines while remaining upright:

Boniva is taken first thing in the morning on an empty stomach with 6 to 8 ounces of plain water once monthly. You must wait a full 60 minutes before taking any food, drinks, or other medicines. During this time you also must remain upright.

Who Should Consider Boniva?

In contrast to other bisphosphonates, the indication for use of Boniva is limited to treatment of postmenopausal women with osteoporosis. Also the effectiveness of Boniva in clinical trials showed reduction of risk for spine fractures but not for non-spine or hip fractures except in a select high-risk group.

Side Effects

The most common side effects are digestive system problems including nausea, heartburn, diarrhea, or constipation.

A “Medication Guide” that is included with the dispensing of Boniva and all the bisphosphonate-class medicines details 5 potential serious side effects:

  1. Esophagus problems
  2. Low calcium levels in your blood (hypocalcaemia)
  3. Severe jaw bone problems (osteonecrosis)
  4. Bone, joint, or muscle pain
  5. Unusual thigh bone fractures

Overall Boniva is well tolerated and these serious side effects occur infrequently. Read more about osteonecrosis of the jaw and atypical femur fractures.

How Long Should You Take Boniva?

The length of use of alendronate and all bisphosphonates is being debated. The recent FDA labeling includes “The optimal duration of use has not been determined. Patients should have the need for continued therapy re-evaluated on a periodic basis.” Find additional information under the topic “drug holiday.”

Discuss with your doctor or healthcare practitioner your individual risk and whether this medicine would be appropriate for you to use.

Other resources:

Product Information from Genentech