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Ibandronate: Drug information

Ibandronate: Drug information
(For additional information see "Ibandronate: Patient drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)
Brand Names: US
  • Boniva [DSC]
Pharmacologic Category
  • Bisphosphonate Derivative
Dosing: Adult

Note: Avoid use of oral ibandronate in patients with swallowing difficulties, esophageal motility disorders, or the inability to stand or sit upright for ≥60 minutes. When appropriate, correct hypocalcemia and vitamin D deficiency (eg, to a 25-hydroxyvitamin D level ≥20 ng/mL [≥50 nmol/L]) prior to initiating therapy and ensure adequate calcium and vitamin D intake during therapy (Ref).

Breast cancer, metastatic bone disease

Breast cancer, metastatic bone disease (treatment; off-label use): IV: 6 mg over 1 to 2 hours every 3 to 4 weeks for up to 4 years (Ref).

Hypercalcemia of malignancy

Hypercalcemia of malignancy (albumin-corrected serum calcium ≥12 mg/dL [≥3 mmol/L]) (alternative agent) (off-label use):

Note: May also be used at the same doses for treatment of hypercalcemia due to excessive bone resorption from other causes (eg, granulomatous diseases, hyperparathyroidism, vitamin D intoxication) (Ref). Asymptomatic or mildly symptomatic patients with chronic hypercalcemia may not require immediate treatment unless albumin-corrected serum calcium level is >14 mg/dL (>3.5 mmol/L) (Ref).

IV: 2 to 6 mg as a single dose over 1 to 2 hours (Ref).

Osteoporosis, postmenopausal, fracture risk reduction

Osteoporosis, postmenopausal, fracture risk reduction:

Note: May be used in patients at risk for vertebral fractures; use has not been associated with reduction in hip or nonvertebral fractures (Ref). Prior to use, evaluate and treat any potential causes of secondary osteoporosis (eg, severe vitamin D deficiency) (Ref).

Patients with high fracture risk, including those with a history of vertebral fragility fracture, or those with a T-score of −2.5 or lower or a T-score between −1 and −2.5 at high fracture risk according to a risk assessment (Ref):

Treatment:

Oral: 150 mg once monthly.

IV: 3 mg every 3 months.

Patients without high fracture risk, including those with a T-score between −1 and −2.5 and who are not at high fracture risk according to a risk assessment, but who desire pharmacologic therapy to prevent bone loss or fracture (Ref):

Prevention: Oral: 150 mg once monthly.

Duration of therapy: The optimal duration of therapy has not been established. If discontinued, the decision to resume therapy is based on multiple factors, including decline in bone mineral density and risk factors for fracture (Ref).

Prostate cancer, metastatic, bone pain

Prostate cancer, metastatic, bone pain (alternative agent if radiation therapy is not an option; off-label use): IV: 6 mg as a single dose over 15 minutes (Ref).

Missed doses:

Oral (once-monthly): If an oral dose is missed, administer the next morning after remembered if the next month's scheduled dose is >7 days away. If the next month's scheduled dose is within 7 days, wait until the next month's scheduled dose. Then return to the original scheduled day of the month on the once-monthly schedule; however, do not administer >150 mg within 7 days.

IV (once every 3 months): If an IV dose is missed, administer as soon as it can be rescheduled. Thereafter, administer every 3 months from the date of the last injection.

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Adult

Osteoporosis: Oral, IV:

CrCl ≥30 mL/minute: No dosage adjustment necessary.

CrCl <30 mL/minute: Use is not recommended.

Dosing: Hepatic Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling (has not been studied); however, ibandronate does not undergo hepatic metabolism.

Dosing: Older Adult

Refer to adult dosing.

Adverse Reactions (Significant): Considerations
Atypical femur fractures

Atypical femur fractures (AFF) have been reported with bisphosphonate use, including ibandronate. The fractures include subtrochanteric femur (bone just below the hip joint) and diaphyseal femur (long segment of the thigh bone). The benefits of therapy (when used for osteoporosis) generally outweigh the absolute risk of AFF within the first 5 years of treatment, especially in patients with high fracture risk (Ref). The risk decreases after bisphosphonate discontinuation (Ref). AFF is estimated to occur in ~0.2% of bisphosphonate users after ≥5 years of therapy (Ref).

Mechanism: Time-related. Long-term suppression of bone turnover may be primarily responsible; however, micro-damage accumulation and alterations of collagen cross-linking have also been postulated (Ref).

Onset: Delayed; most fractures have occurred in patients receiving bisphosphonates for at least 3 to 5 years (Ref). Patients may experience prodromal pain weeks or months before the fracture occurs (Ref).

Risk factors:

• Long-term treatment (>3 to 5 years) (Ref)

• Asian race (in North America) (Ref)

• Femoral bowing (Ref)

• Glucocorticoid use (>1 year) (Ref)

GI mucosal irritation

Esophagitis, dysphagia, esophageal ulcer, erosive esophagitis, esophageal stenosis (rare), and esophageal perforation (rare) have been reported with other bisphosphonates (Ref). Oropharyngeal ulcer has also been noted (Ref). Ibandronate appears to be well tolerated from a GI reaction standpoint (Ref). However, reactions may represent a class effect, including oral ibandronate. Experiencing a GI event increases the likelihood of decreased adherence at 1 year (Ref) or discontinuation (Ref).

Mechanism: GI mucosal irritation is secondary to the local effect on the gastric mucosa (as opposed to a systemic effect) (Ref).

Onset: Varied; dependent upon the type of mucosal injury but case reports have noted onset within 2 days to 12 months after initiation (Ref).

Risk factors:

• Oral administration (versus IV administration) (Ref)

• Incorrect administration technique (oral only) (ie, <180 mL water, lying down after administration) (Ref)

• Older adults (Ref)

• Concurrent nonsteroidal anti-inflammatory drug or antithrombotic use (Ref)

• Prior GI issues (Ref)

Hypocalcemia

While transient hypocalcemia is expected with the use of ibandronate (and all bisphosphonates) secondary to their mechanism of action, cases of symptomatic hypocalcemia are rare with oral ibandronate (Ref). Intravenous ibandronate can cause both asymptomatic (Ref) and symptomatic hypocalcemia. Hypocalcemia is typically quickly reversible with either discontinuation of ibandronate or use of supportive care measures (Ref). In a systematic review of clinically significant hypocalcemia in patients receiving IV bisphosphonates for bone metastases (including ibandronate), incidence ranged from 1% to 2% (Ref). When compared to pamidronate, IV ibandronate appears to have a higher incidence of hypocalcemia (Ref).

Mechanism: By decreasing osteoclast activity, calcium is not released into the bloodstream, causing a transient decrease in blood calcium. In patients with normally functioning parathyroid glands, calcium homeostasis is regained shortly after starting the bisphosphonate (Ref).

Onset: IV: Rapid; hypocalcemia can occur within the first few days after IV infusion of ibandronate. Oral: Intermediate; hypocalcemia typically occurs within weeks of the start of oral ibandronate (Ref).

Risk factors:

• Baseline hypocalcemia (Ref)

• Impaired kidney function (Ref)

• Impaired parathyroid function (Ref)

• IV bisphosphonate (Ref)

• Vitamin D deficiency (Ref)

• Hypomagnesemia (Ref)

• Concurrent medications (eg, interferon-alfa, aminoglycosides, loop diuretics) (Ref)

• Close dosing intervals (Ref)

Influenza-like illness/acute phase reaction

Acute phase reaction-like symptoms/flu-like symptoms are not life-threatening, reversible, and typically either not observed beyond the first dose of the bisphosphonate or symptoms are less significant with subsequent exposure (Ref). While more common when bisphosphonates are used IV (Ref), it has also been documented with oral use of ibandronate (Ref). The reaction can manifest as influenza-like symptoms, such as fatigue, arthralgia, and bone pain as well as fever and rigors (Ref). Resolution is usually observed within 2 to 3 days after symptom onset but may last up to 7 to 14 days (Ref).

Mechanism: Appears to be mediated by interleukin-6, tumor necrosis factor (TNF)-alpha, and other pro-inflammatory cytokines (Ref).

Onset: Rapid; typically manifests within the first 3 days (Ref).

Risk factors:

• IV dosing (Ref)

• Nitrogen-containing bisphosphonates (eg, ibandronate) (Ref)

• Less frequent oral dosing (Ref)

Osteonecrosis of the jaw

Osteonecrosis of the jaw (ONJ) was first described in the dental literature (Ref) with the use of IV bisphosphonates, and several case reports of ONJ with IV ibandronate exist. However, there is conflicting evidence of whether this risk is seen with oral bisphosphonates or is simply an increased risk in those who are treated with agents for osteoporosis (Ref). ONJ is most commonly reversible and not life-threatening; however, the possibility of ONJ significantly increases the risk of nonadherence (Ref).

Mechanism: Dose- and time-related; exact mechanism unknown, but several hypothesized mechanisms exist, such as over-suppression of bone turnover (Ref), mucosal toxicity (Ref), cytokine-mediated inflammation (Ref), and infection (Ref).

Onset: Varied; can be spontaneous or after insult, such as tooth extraction and/or dental implant procedures (Ref).

Risk factors:

• Alcohol use disorder (Ref)

• Anemia (Ref)()

• Cancer and anticancer therapy (Ref)

• Corticosteroid therapy (Ref)

• Dental extraction and/or dental implant procedures (Ref)

• Diabetes (Ref)

• Extended duration (>3 years) of bisphosphonate (Ref)

• High-dose, IV bisphosphonate (Ref)

• Immunological disorders (Ref)

• Oral surgery or trauma (Ref)

• Poor oral hygiene (Ref)

• Poorly fitting dental appliance (Ref)

• Radiotherapy to head and neck (Ref)

• Tobacco smoking (Ref)

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

1% to 10%:

Cardiovascular: Hypertension (oral: 6%)

Dermatologic: Skin rash (2%)

Gastrointestinal: Abdominal pain (5% to 8%), constipation (3% to 4%), diarrhea (3% to 5%), dyspepsia (4% to 6%), gastritis (IV: 2%), gastroenteritis (IV: 2%), nausea (2% to 5%)

Genitourinary: Cystitis (IV: 2%), urinary tract infection (2% to 3%)

Hypersensitivity: Acute phase reaction-like symptoms (9% to 10%)

Infection: Influenza (4% to 5%)

Local: Injection site reaction (IV: 2%)

Nervous system: Depression (IV: 1%), dizziness (2%), fatigue (IV: 3%), headache (3% to 4%), insomnia (1% to 2%)

Neuromuscular & skeletal: Arthralgia (6% to 10%), back pain (5% to 7%), limb pain (3% to 4%), localized osteoarthritis (2% to 3%), muscle cramps (oral: 2%), myalgia (2% to 3%)

Respiratory: Bronchitis (2% to 3%), flu-like symptoms (2% to 5%), nasopharyngitis (3% to 4%), upper respiratory tract infection (1% to 2%)

<1%: Ophthalmic: Scleritis, uveitis

Postmarketing:

Cardiovascular: Prolonged QT interval on ECG (Bonilla 2014)

Dermatologic: Bullous dermatitis, erythema multiforme (Song 2019), Stevens-Johnson syndrome

Endocrine & metabolic: Hypocalcemia (Papapetrou 2009)

Hypersensitivity: Anaphylactic shock, anaphylaxis, angioedema

Neuromuscular & skeletal: Femur fracture (diaphyseal or subtrochanteric) (Park-Wyllie 2011), musculoskeletal pain (bone, joint, or muscle; incapacitating), osteonecrosis (oro-facial sites including the external auditory canal), osteonecrosis of the jaw (Lewiecki 2011)

Ophthalmic: Iritis

Renal: Acute kidney injury

Respiratory: Bronchospasm, exacerbation of asthma

Contraindications

Known hypersensitivity to ibandronate or any component of the formulation; hypocalcemia; oral tablets are also contraindicated in patients unable to stand or sit upright for at least 60 minutes and in patients with abnormalities of the esophagus which delay esophageal emptying, such as stricture or achalasia.

Warnings/Precautions

Concerns related to adverse effects:

• Bone/joint/muscle pain: Infrequently, severe (and occasionally debilitating) bone, joint, and/or muscle pain have been reported during bisphosphonate treatment. The onset of pain ranged from a single day to several months. Discontinue intravenous ibandronate therapy in patients who experience severe symptoms; symptoms usually resolve upon discontinuation. Some patients experienced recurrence when rechallenged with the same drug or another bisphosphonate; avoid use in patients with a history of these symptoms in association with bisphosphonate therapy.

• Hypersensitivity: Allergic reactions, including anaphylactic reaction/shock (some fatal), angioedema, bronchospasm, exacerbation of asthma, rash, Stevens-Johnson syndrome, erythema multiforme, and dermatitis bullous have been reported; discontinue if hypersensitivity reaction occurs.

• Ocular effects: Uveitis and scleritis have been reported with ibandronate; patients presenting with signs of ocular inflammation may require further ophthalmologic evaluation.

Disease-related concerns:

• Bariatric surgery: Altered absorption and ulceration risk: Avoid oral bisphosphates after bariatric surgery; inadequate oral absorption and potential anastomotic ulceration may occur. If therapy is indicated, IV administered bisphosphonates are recommended.

• Renal impairment: Use not recommended with severe renal impairment (CrCl <30 mL/minute). Intravenous bisphosphonate use has been associated with renal deterioration, including acute renal failure.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Solution, Intravenous:

Boniva: 3 mg/3 mL (3 mL [DSC])

Solution, Intravenous [preservative free]:

Generic: 3 mg/3 mL (3 mL)

Tablet, Oral:

Boniva: 150 mg [DSC]

Generic: 150 mg

Generic Equivalent Available: US

Yes

Pricing: US

Solution (Ibandronate Sodium Intravenous)

3 mg/3 mL (per mL): $166.67 - $168.40

Tablets (Ibandronate Sodium Oral)

150 mg (per each): $138.73 - $165.12

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Administration: Adult

Oral: Administer 60 minutes before the first food or drink of the day (other than water) and prior to taking any oral medications or supplements (eg, calcium, antacids, vitamins). Ibandronate should be taken in an upright position with a full glass (6 to 8 oz) of plain water and the patient should avoid lying down for 60 minutes to minimize the possibility of GI side effects. Mineral water with a high calcium content should be avoided. The tablet should be swallowed whole; do not chew or suck. Do not eat or drink anything (except water) for 60 minutes following administration of ibandronate.

IV: Administer as a 15 to 30 second bolus IV; avoid paravenous or intraarterial administration (may cause tissue damage). Do not mix with calcium-containing solutions or other drugs. For osteoporosis, do not administer more frequently than every 3 months.

Off-label rates: Infuse over 1 to 2 hours for metastatic bone disease due to breast cancer and for hypercalcemia of malignancy (Ref). Infuse over 15 minutes for metastatic bone pain due to prostate cancer (Ref).

Medication Guide and/or Vaccine Information Statement (VIS)

An FDA-approved patient medication guide, which is available with the product information and as follows, must be dispensed with this medication:

Boniva injection: http://www.accessdata.fda.gov/drugsatfda_docs/label/2016/021858s022lbl.pdf#page=18

Boniva tablets: http://www.accessdata.fda.gov/drugsatfda_docs/label/2016/021455s021lbl.pdf#page=19

Use: Labeled Indications

Osteoporosis, postmenopausal, fracture risk reduction: Treatment and prevention of postmenopausal osteoporosis.

Use: Off-Label: Adult

Breast cancer, metastatic bone disease (treatment); Hypercalcemia of malignancy; Prostate cancer, metastatic, bone pain (alternative agent)

Metabolism/Transport Effects

None known.

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.

Aminoglycosides: May enhance the hypocalcemic effect of Bisphosphonate Derivatives. Aminoglycosides may enhance the nephrotoxic effect of Bisphosphonate Derivatives. Risk C: Monitor therapy

Angiogenesis Inhibitors (Systemic): May enhance the adverse/toxic effect of Bisphosphonate Derivatives. Specifically, the risk for osteonecrosis of the jaw may be increased. Risk C: Monitor therapy

Capecitabine: Bisphosphonate Derivatives may enhance the nephrotoxic effect of Capecitabine. Risk C: Monitor therapy

Deferasirox: Bisphosphonate Derivatives may enhance the adverse/toxic effect of Deferasirox. Specifically, the risk for GI ulceration/irritation or GI bleeding may be increased. Risk C: Monitor therapy

Inhibitors of the Proton Pump (PPIs and PCABs): May diminish the therapeutic effect of Bisphosphonate Derivatives. Risk C: Monitor therapy

Nonsteroidal Anti-Inflammatory Agents: May enhance the adverse/toxic effect of Bisphosphonate Derivatives. Both an increased risk of gastrointestinal ulceration and an increased risk of nephrotoxicity are of concern. Risk C: Monitor therapy

Polyvalent Cation Containing Products: May decrease the serum concentration of Bisphosphonate Derivatives. Management: Avoid administration of oral medications containing polyvalent cations within: 2 hours before or after tiludronate/clodronate/etidronate; 60 minutes after oral ibandronate; or 30 minutes after alendronate/risedronate. Risk D: Consider therapy modification

Food Interactions

Food may reduce absorption; mean oral bioavailability is decreased up to 90% when given with food. Management: Take with a full glass (6-8 oz) of plain water, at least 60 minutes prior to any food, beverages, or medications. Mineral water with a high calcium content should be avoided. Wait at least 60 minutes after taking ibandronate before taking anything else.

Reproductive Considerations

Underlying causes of osteoporosis should be evaluated and treated prior to considering bisphosphonate therapy in premenopausal women; effective contraception is recommended when bisphosphonate therapy is required (Pepe 2020). Bisphosphonates are incorporated into the bone matrix and gradually released over time. Because exposure prior to pregnancy may theoretically increase the risk of fetal harm, most sources recommend discontinuing bisphosphonate therapy in females of reproductive potential as early as possible prior to a planned pregnancy. Use in premenopausal females should be reserved for special circumstances when rapid bone loss is occurring; a bisphosphonate with the shortest half-life should then be used (Bhalla 2010; Pereira 2012; Stathopoulos 2011).

Pregnancy Considerations

It is not known if bisphosphonates cross the placenta, but based on their lower molecular weight, fetal exposure is expected (Djokanovic 2008; Stathopoulos 2011).

Information related to the use of ibandronate in pregnancy is limited (El-Safadi 2012).

Bisphosphonates are incorporated into the bone matrix and gradually released over time. The amount available in the systemic circulation varies by drug, dose, and duration of therapy. Theoretically, there may be a risk of fetal harm when pregnancy follows the completion of therapy (hypocalcemia, low birth weight, and decreased gestation have been observed in some case reports); however, available data have not shown that exposure to bisphosphonates during pregnancy significantly increases the risk of adverse fetal events (Djokanovic 2008; Green 2014; Levy 2009; Machairiotis 2019; Sokal 2019; Stathopoulos 2011). Exposed infants should be monitored for hypocalcemia after birth (Djokanovic 2008; Stathopoulos 2011).

Breastfeeding Considerations

It is not known if ibandronate is present in breast milk.

Dietary Considerations

Ensure adequate calcium and vitamin D intake; if dietary intake is inadequate, dietary supplementation is recommended. Patients should consume:

Calcium: 1,000 mg/day (males: 50 to 70 years of age) or 1,200 mg/day (females ≥51 years of age and males ≥71 years of age) (IOM 2011; NOF [Cosman 2014]).

Vitamin D: 800 to 1,000 units daily (age ≥50 years) (NOF [Cosman 2014]). Recommended dietary allowance (RDA): 600 units daily (age ≤70 years) or 800 units daily (age ≥71 years) (IOM 2011).

Monitoring Parameters

Osteoporosis: Serial bone mineral density (BMD) should be evaluated at baseline and every 1 to 3 years on treatment (usually at ~2 years following initiation of therapy, then more or less frequently depending on patient-specific factors and stability of BMD) (AACE/ACE [Camacho 2020]; ES [Eastell 2019]; NOF [Cosman 2014]); evaluate BMD every 2 to 4 years during a drug holiday (ES [Eastell 2019]); serum creatinine prior to each IV dose; annual measurements of height and weight, assessment of chronic back pain; serum calcium (prior to and during therapy) and 25(OH)D; may consider measuring biochemical markers of bone turnover (eg, fasting serum CTX or urinary NTX) at baseline, 3 months, and 6 months, to assess treatment response, adherence to therapy, and/or possible malabsorption (ES [Eastell 2019]); femur fracture in patients presenting with thigh or groin pain (during or after treatment; if fracture identified, also evaluate contralateral limb).

Mechanism of Action

A bisphosphonate which inhibits bone resorption via actions on osteoclasts or on osteoclast precursors; decreases the rate of bone resorption, leading to an indirect increase in bone mineral density.

Pharmacokinetics (Adult Data Unless Noted)

Distribution: Terminal Vd: 90 L; 40% to 50% of circulating ibandronate binds to bone

Protein binding: 85.7% to 99.5%

Metabolism: Not metabolized

Bioavailability: Oral: Minimal; reduced ~90% following standard breakfast

Half-life elimination:

Oral: 150 mg dose: Terminal: 37 to 157 hours

IV: Terminal: ~5 to 25 hours

Time to peak, plasma: Oral: 0.5 to 2 hours

Excretion: Urine (50% to 60% of absorbed dose, excreted as unchanged drug); feces (unabsorbed drug)

Pharmacokinetics: Additional Considerations (Adult Data Unless Noted)

Altered kidney function: Patients with CrCl 40 to 70 mL/minute had 55% higher AUC and patients with CrCl 30 mL/minute had more than a 2-fold increase in exposure.

Older adult: Progressive age-related changes in renal function may alter the elimination of ibandronate in elderly patients.

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (AE) United Arab Emirates: Bondronat | Bonviva;
  • (AR) Argentina: Adromux | Bandrobon | Bantuc | Brexell plus | Elasterin | Femorel | Fijacal | Ibandronato Richet | Ibanleg | Intersules | Mesel | Modifical | Oseum | Osteotrex | Posclim | Silidral uno | Tabtil;
  • (AT) Austria: Bondronat | Bonviva | Ibandronic acid accord | Ibandronsaeure ratiopharm | Ibandronsaeure sandoz | Osteonat | Osteoviva;
  • (AU) Australia: Bondronat;
  • (BD) Bangladesh: Bonaid | Boncare | Bondrix | Bondrova | Bone guard | Bonfix | Bonmax | Bonova | Droniva | Ibandron | Idrofos | Ivana | Maxbon | Ostiban;
  • (BE) Belgium: Bondronat | Bonviva | Ibandronate Apotex | Ibandronate eg | Ibandronate Mylan | Ibandronic acid accord | Ibandronic acid sandoz | Ibandronic acid teva | Mirdezel | Quodixor;
  • (BF) Burkina Faso: Femorel;
  • (BG) Bulgaria: Bondronat | Bonviva | Iasibon | Ibandronic acid | Ibandronic acid teva | Ivadron | Kefort | Osbonelle | Ossica | Quodixor;
  • (BR) Brazil: Afrat | Bonviva | Iban | Iband | Ibandronato de sodio | Ibandronato de sodio monoidratado | Ibaness | Ibanuno | Osbant | Osteoban | Osteotec | Sintezys;
  • (CH) Switzerland: Bondronat | Bonviva | Ibandronat Actavis | Ibandronat helvepharm osteo | Ibandronat Mepha | Ibandronat Sandoz | Ibandronat spirig hc;
  • (CI) Côte d'Ivoire: Bonviva | Femorel;
  • (CL) Chile: Adromux | Bondronat | Bonviva | Dronaval | Ibadrox | Ibanox | Idena | Recaxin;
  • (CN) China: Ai ben | Bondronat | Ibandronate monoso | Jia nuo shun;
  • (CO) Colombia: Acido ibandronico | Bandro | Bandro o | Bonames | Bondronat | Bonviva | Conaciban o | Droniban | Ibanat | Ibandromas | Ibandromet | Ibandron | Ibandronato | Ibanic | Idena | Meliba | Oseban | Osteocalcit | Osteolong | Unomes;
  • (CZ) Czech Republic: Bondronat | Flastin | Gerousia | Holmevis | Iasibon | Ibandronat Apotex | Ibandronat Mylan | Ibandronic acid accord | Ibandronic acid aurobindo | Ibandronic acid sandoz | Ibandronic acid stada | Ibandronic acid teva | Ikametin | Licobondrat | Osagrand | Phacebonate;
  • (DE) Germany: Bondronat | Bonoste | Bonviva | Iasibon | Ibandronate | Ibandronic acid accord | Ibandronsaeure | Ibandronsaeure 1A pharma | Ibandronsaeure actavis | Ibandronsaeure AL | Ibandronsaeure Cell pharm | Ibandronsaeure CT | Ibandronsaeure Hexal | Ibandronsaeure Ibisqus | Ibandronsaeure Juta | Ibandronsaeure Onkovis | Ibandronsaeure ratiopharm | Ibandronsaeure sandoz | Ibandronsaeure Stada | Ribobandron;
  • (DO) Dominican Republic: Acido ibandronico | Adromux | Bandrocare aglf | Bifosfan | Bondronat | Bonviva | Denual | Ibandronato mamey | Ibandronato mk | Idena | Ipexal | Osteox | Recaxin | Unoiban;
  • (EC) Ecuador: Aciberkan | Acido ibandronico | Bonames | Bondronat | Denual | Dronaval | Femorel | Ibandromet | Ibandronato mk | Ibandrox | Ibanflex | Ibrac | Idena | Oseban | Recaxin | Rubir;
  • (EE) Estonia: Baxogar | Ibandronic acid accord | Ibandronic acid teva | Ossica;
  • (EG) Egypt: Bonprove | Ibandrocare;
  • (ES) Spain: Abrion | Acido ibandronico actavis | Acido ibandronico alter | Acido ibandronico amneal | Acido ibandronico apotex | Acido ibandronico aurobindo | Acido Ibandronico Cinfa | Acido ibandronico combix | ACido Ibandronico Kern pharma | Acido ibandronico mylan | Acido ibandronico normon | Acido ibandronico qualigen | Acido ibandronico ranbaxy | Acido Ibandronico Ratiopharm | Acido ibandronico sandoz | Acido ibandronico stada | Acido ibandronico tecnigen | Acido ibandronico teva | Acido ibandronico vir | Bondenza | Bondronat | Bonviva;
  • (FI) Finland: Bondronat | Bonviva | Clastec | Ibamyl | Ibandronat Actavis | Ibandronat stada | Ibandronate Ratiopharm | Ibandronic acid accord;
  • (FR) France: Acide ibandronique teva;
  • (GB) United Kingdom: Bondronat | Bonviva | Iasibon | Ibandronic acid | Ibandronic acid accord | Ibandronic acid actavis | Ibandronic acid Kent | Ibandronic acid mylan | Ibandronic acid sandoz | Ibandronic acid teva | Quodixor;
  • (GR) Greece: Axibal | Bondronat | Bone free | Iasibon | Ibanate | Ibandronic acid Specifar | Ibondem | Ibosat | Ozilen | Sedropor | Spesostoun | Voliran;
  • (HK) Hong Kong: Bondronat | Bonjenic | Bonviva;
  • (HR) Croatia: Bondronat | Bonnedra | Bonosta | Bonviva | Ibadron | Ibandronat PharmaS | Ibandronat Sandoz | Ibat | Ostea;
  • (HU) Hungary: Bondronat | Bonessa | Holmevis | Ibandronate pharmacenter | Ibandronic acid accord | Ibandronsav | Ibandronsav gentian generics | Ibandronsav sandoz | Ibandronsav Teva | Osagrand | Ossica | Phacebonate | Quodixor;
  • (ID) Indonesia: Bondronat | Bonviva;
  • (IE) Ireland: Bondronat | Bonefurbit | Bonviva | Ibandronic acid | Osbonelle | Quodixor;
  • (IN) India: Bandrone | Bonrise | Egyban | Flurish | Gemidro | Iban plus | Idrofos | Idromet | Irbez | Monthiba | Vebalone;
  • (IT) Italy: Acido ibandronico | Acido ibandronico accord | Acido ibandronico actavis | Acido ibandronico aurobindo | Acido ibandronico bluefish | Acido ibandronico doc generici | Acido ibandronico germed | Acido ibandronico mylan | Acido ibandronico pensa | Acido ibandronico sandoz | Acido ibandronico tecnigen | Acido ibandronico teva | Acido ibandronico zentiva | Baxogar | Bondronat | Bonviva | Ibostofar;
  • (JO) Jordan: Bondronat | Bonviva;
  • (JP) Japan: Bonviva;
  • (KE) Kenya: Baron | Bondronat | Bonviva | Cadronate | I fos | Ibandro;
  • (KR) Korea, Republic of: Ahngook ibandronate sodium | Amicabone | Amikabon | Anabon | Bandron | Bandronate | Bonbis | Bondan | Bondex | Bondronat | Bonegard | Bonevega | Bonezoa | Boni M | Bonivan | Bonjenic | Bonviva | Dongkwang ibandronic acid | Droban | Drobone | Evebone | Gendron | Haniban | Ibabon | Ibandqual | Ibandren | Ibandron | Ibanel | Ibannate | Ibateron | Ibondens | Ibondro | Il yang ibandronate | Ironsan | Kyongbo ibandronate | Osmac | Proiban | Unibiba | Unibone | Vivadron | Yuyu ibandronate sodium;
  • (LB) Lebanon: Adromux | Bonafor | Bondronat | Bonviva;
  • (LT) Lithuania: Baxogar | Bondronat | Ibandronic acid briz | Ibandronic Acid Ingen Pharma | Ibandronic acid mylan | Osagrand | Ossica;
  • (LU) Luxembourg: Bondronat | Bonviva | Ibandronate eg | Ibandronate mithra;
  • (LV) Latvia: Baxogar | Bondronat | Iasibon | Ibandronic acid accord | Ibandronic acid ratiopharm | Ibandronic acid teva | Ivadron | Osagrand | Ossica;
  • (MA) Morocco: Ibandro zenith;
  • (MX) Mexico: Acido ibandronico apotex | Bondronat | Bonviva | Dabran | Fosfonat;
  • (MY) Malaysia: Bondronat | Bonviva;
  • (NL) Netherlands: Bondronat | Bonviva | Ibandroninezuur Actavis | Ibandroninezuur aurobindo | Ibandroninezuur Mylan | Ibandroninezuur Sandoz | Ibandroninezuur xiromed;
  • (NO) Norway: Bondronat | Bonviva | Ibandronsyre medical valley;
  • (PE) Peru: Bandrex | Bonames | Bonil | Bonviva | Brexell plus | Brexi plus | Dronaval | Ibames | Ibandra | Ibandroporosis | Ibonix | Idena | Ipexal | Maxibone | Oseban | Osteoban | Osteosyl | Resormes | Reumol;
  • (PH) Philippines: Bondronat | Bonviva;
  • (PK) Pakistan: Adronil | Bionic | Bondronat | Bonheal | Bonvir | Bonviva | Boonest | Filbone | Franjic | Ibandro | Ibnate | Ironic | Jupiter | Oseban | Osfit | Ostenate | Ronate | Winbendra;
  • (PL) Poland: Bonviva | Ibandronat Apotex | Ibandronat Polpharma | Ibandronic acid | Ibandronic Acid Aurovitas | Ibandronic acid mylan | Ibandronic acid teva | Kefort | Nucodran | Osagrand | Ossica | Ostone | Quodixor;
  • (PR) Puerto Rico: Boniva;
  • (PT) Portugal: Acido ibandronico | Acido ibandronico actavis | Acido ibandronico alter | Acido ibandronico aurobindo | Acido ibandronico bluepharma | Acido ibandronico farmoz | Acido Ibandronico GP | Acido Ibandronico Pentafarma | Acido ibandronico pharmakern | Acido ibandronico teva | Baxogar | Bondronat | Etanorden;
  • (PY) Paraguay: Adromux | Benzidol | Bondronat | Bonviva | Dronaval | Femorel | Ibadrona | Idena | Layax | Recaxin | Tefal;
  • (QA) Qatar: Bonviva;
  • (RO) Romania: Acid ibandronic accord | Acid ibandronic aurobindo | Acid ibandronic glenmark | Acid ibandronic sandoz | Acid ibandronic teva | Bondronat | Bonviva | Holmevis | Iasibon | Osagrand | Ossica | Quodixor;
  • (RU) Russian Federation: Bondronat | Bonviva | Rezoviva;
  • (SA) Saudi Arabia: Bonviva;
  • (SE) Sweden: Bondronat | Bonviva | Iasibon | Ibandronat stada | Ibandronate Bluefish | Ibandronic acid accord | Ibandronic acid sandoz;
  • (SG) Singapore: Bondronat;
  • (SI) Slovenia: Bondronat | Ibandronska kislina Teva;
  • (SK) Slovakia: Bondronat | Bonviva | Flastin | Gerousia | Iasibon | Ibandronat Actavis | Ibandronic acid mylan | Ibandronic acid stada | Ikametin | Kefort | Kyselina ibandronova Teva | Licobondrat | Osagrand | Ossica | Phacebonate;
  • (TH) Thailand: Bondronat | Bonviva | Ibonate;
  • (TN) Tunisia: Bondronat;
  • (TR) Turkey: Bondronat | Bonviva | Ibamax | Ibanos | Ibofix | Kemidat | Kemiva | Osiban | Sempriban;
  • (TW) Taiwan: Bondronat | Keybone;
  • (UA) Ukraine: Bandrone | Bonablast | Bondronat | Ibandronic acid | Ibandronic acid Pharmex;
  • (UY) Uruguay: Adromux | Andromux | Femorel;
  • (VE) Venezuela, Bolivarian Republic of: Acido ibandronico | Acler | Bonviva | Denual | Ibandromet | Ibone | Idena;
  • (ZA) South Africa: Aspen ibandronate | Bondronat | Boniva;
  • (ZW) Zimbabwe: Bonviva
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Topic 8887 Version 310.0

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