Indications for BONIVA:
Prevention and treatment of postmenopausal osteoporosis.
Limitations of Use:
Optimal duration of use has not been determined. For patients at low-risk for fracture: consider drug discontinuation after 3–5yrs.
Swallow whole. Take in the AM with plain (not mineral) water (6–8oz), at least 60mins before the first food, drink, or medication of the day; do not lie down for at least 60mins after. 150mg once monthly (take on the same day each month). If dose is missed, do not take two 150mg tablets within the same week.
Hypocalcemia. Tabs: Esophagus abnormalities which delay esophageal emptying (eg, stricture, achalasia). Inability to stand or sit upright for at least 60mins.
Active upper GI disease; discontinue and reevaluate if signs/symptoms of esophageal reaction occur. Severe renal impairment (CrCl <30mL/min): not recommended. Correct preexisting hypocalcemia, other mineral or bone disturbances before starting. Risk of osteonecrosis of the jaw; consider discontinuing therapy during invasive dental procedures (eg, tooth extraction, implants, surgery). History of bisphosphonate exposure: evaluate for atypical fractures if thigh/groin pain develops; consider withholding therapy until risk/benefit assessment. Ensure adequate Vit. D and calcium intake. Reevaluate periodically. Inj: check renal function before each dose. Pregnancy. Nursing mothers.
Calcium, aluminum, magnesium, other multivalent cations reduce absorption (separate dosing by at least 60mins). Caution with aspirin, NSAIDs, other GI irritants. May interfere with bone-imaging agents. Inj: concomitant nephrotoxic agents; monitor for renal toxicity.
Back pain, dyspepsia, pain in extremity, diarrhea, headache, myalgia; musculoskeletal pain (discontinue if severe), esophagitis, esophageal or gastric ulcer, jaw osteonecrosis, atypical femur fractures. Inj: inj site reactions, flu-like syndrome, anaphylaxis.
Generic Drug Availability:
Blister pack—3; Kit—1 (prefilled syringe + supplies)