Boniva Warnings and Precautions

Before starting osteoporosis treatment with Boniva, warnings and precautions for the drug should be discussed with your healthcare provider. It is important to know that Boniva may cause damage to the esophagus, extreme muscle or bone pain, and osteonecrosis of the jaw. Boniva warnings and precautions also extend to people with kidney disease, low blood calcium, or problems with the esophagus.

Boniva: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking Boniva® (ibandronate sodium) if you:
  • Have low blood calcium (hypocalcemia)
  • Cannot sit or stand for one hour
  • Have kidney disease, including kidney failure (renal failure)
  • Have difficulty swallowing or other problems with your esophagus
  • Have any allergies, including allergies to food, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding
  • Planning to have a dental procedure.
Make sure to tell your healthcare provider about all medicines you may be taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Specific Boniva Warnings and Precautions

Warnings and precautions to be aware of prior to taking Boniva include the following:
  • There have been rare reports of unusual broken thigh bones in people taking bisphosphonate medications like Boniva. It is not yet clear if the medications are to blame, since the fractures could simply be due to osteoporosis or other factors. These fractures typically were not caused by trauma or injury. Let your healthcare provider know if you have unexplained groin or thigh pain, as these are sometimes signs of thigh fractures.


  • Boniva, like all bisphosphonate medications, can irritate or damage the esophagus and stomach. This can lead to indigestion, heartburn, or even ulcers. Let your healthcare provider know if you notice any of these problems while taking Boniva.
  • It is important to get enough calcium and vitamin D (either through your diet or by supplementation). Calcium and vitamin D are necessary for rebuilding bone and preventing further bone loss.
  • Boniva may not be recommended for people with severe kidney disease.
  • In rare cases, bisphosphonates (including Boniva) have caused a condition called osteonecrosis of the jaw. This is a serious, possibly disfiguring problem in which the bone of the jaw dies. Often, there are symptoms (such as pain, infection, or loosening of the teeth), but sometimes there are no symptoms until a person notices exposed bone.
This problem is most common when bisphosphonates are given by IV (but is still possible when these medications are taken orally). It seems that people who have dental procedures (such as a tooth extraction) are also at higher risk. Be sure to take good care of your mouth and teeth by seeing your dentist frequently. Let your healthcare provider know right away if you think you may have osteonecrosis of the jaw.
  • In rare cases, bisphosphonates (including Boniva) can cause extreme muscle or bone pain. This usually goes away once the medication is stopped.
  • Boniva can potentially interact with a number of medications (see Boniva Drug Interactions).
  • Boniva is considered a pregnancy Category C medication. This means that it may not be safe for use during pregnancy (see Boniva and Pregnancy).
  • It is not known whether Boniva passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Boniva and Breastfeeding).
Men and Osteoporosis

Boniva for Osteoporosis

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