Ibandronate Injection (patient information)

# Why this medication is prescribed
Ibandronate injection is used to treat osteoporosis (a condition in which the bones become thin and weak and break easily) in women who have undergone menopause ('change of life,' end of menstrual periods). Ibandronate is in a class of medications called bisphosphonates. It works by preventing bone breakdown and increasing bone density (thickness).

# How this medication should be used
Ibandronate injection comes as a solution (liquid) to be injected into a vein. Ibandronate injection is given only by a health care provider usually once every 3 months. Do not give an ibandronate injection to yourself.
Ibandronate injection controls osteoporosis but does not cure it. Ibandronate injection helps to treat osteoporosis only as long as you receive regular injections. It is important that you receive your ibandronate injection once every 3 months for as long as your health care provider prescribes it.
Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

# Other uses for this medicine
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

# Special precautions
Before receiving ibandronate injection:
- tell your doctor and pharmacist if you are allergic to ibandronate, any other medications, or any of the ingredients in ibandronate injection. Ask your doctor for a list of the ingredients.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you have hypocalcemia (lower than normal level of calcium in your blood). Your doctor will probably tell you not to use ibandronate injection.
- tell your doctor if are undergoing radiation therapy and if you have or have ever had anemia (condition in which the red blood cells do not bring enough oxygen to all the parts of the body); cancer;diabetes; any type of infection, especially in your mouth; problems with your mouth, teeth, or gums; high blood pressure; any condition that stops your blood from clotting normally; lower than normal levels of Vitamin D;or heart, or kidney disease.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding.Also tell your doctor if you plan to become pregnant at any time in the future, because ibandronate may remain in your body for many years after you stop taking it. Call your doctor if you become pregnant during or after your treatment.
- you should know that ibandronate injection may cause serious problems with your jaw, especially if you have dental surgery or treatment while you are being treated with ibandronate injection. A dentist should examine your teeth and perform any needed treatments before you start treatment with ibandronate injection. Be sure to brush your teeth and clean your mouth properly while you are being treated with ibandronate injection. Talk to your dentist before having any dental treatments while you are receiving this medication.
- you should know that ibandronate injection may cause flu-like symptoms including fever; chills; joint, bone and/or muscle pain; and excessive tiredness. These symptoms usually occur only after the first ibandronate injection and generally do not happen again during treatment. *Your health care provider or pharmacist can suggest a mild pain reliever to make you more comfortable. Without treatment, these symptoms usually disappear within 24 to 48 hours. Call your doctor if these symptoms get worse or do not go away.
- talk to your doctor about other things you can do to prevent osteoporosis from developing or worsening. Your doctor will probably tell you to avoid smoking and drinking large amounts of alcohol and to follow a regular program of weight-bearing exercise.

# Special dietary instructions
Your doctor will tell you to take supplements of calcium and vitamin D while you are being treated with ibandronate injection.

# What to do if you forget a dose
If you miss an appointment to receive an injection of ibandronate, you should call your health care provider as soon as possible. The missed dose should be given as soon as it can be rescheduled.After you receive the missed dose, your next injection should be scheduled 3 months from the date of your last injection. You should not receive an ibandronate injection more often than once every 3 months.

# Side effects

## Minor side effects
Ibandronate injection may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- stomach pain
- nausea
- constipation
- diarrhea
- heartburn
- back pain
- rash
- bone, joint, or muscle pain
- pain in the arms or legs
- weakness
- tiredness
- dizziness
- headache
- fever, sore throat, chills, cough, and other signs of infection
- frequent or urgent need to urinate
- painful urination
- redness, or swelling at injection spot

## Severe side effects
Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately before receiving any more ibandronate injection:
- painful or swollen gums
- loosening of the teeth
- numbness or heavy feeling in the jaw
- poor healing of the jaw
- eye pain or swelling
- vision changes
- sensitivity to light
Ibandronate injection may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

# In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

# Other information
Keep all appointments with your doctor and the laboratory. Your doctor will order certain tests to check your body's response to ibandronate injection.
Before having any bone imaging study, tell your doctor and health care personnel that you are receiving ibandronate injection

# Brand names
- Boniva Injection