Does not induce or inhibit CYP isoenzymes (i.e., CYP1A2, 2A6, 2C9, 2C19, 2D6, 2E1, or 3A4)  and is not metabolized. 
Antacids or Mineral Supplements Containing Divalent Cations
Pharmacokinetic interaction (decreased absorption of ibandronate) when tablets are used concomitantly with antacids or mineral supplements containing divalent cations (e.g., aluminum, calcium, magnesium, iron). Administer tablets ≥60 minutes prior to such drugs or supplements.
Drugs Affecting Hepatic Microsomal Enzymes
Pharmacokinetic interactions unlikely.
Drugs Excreted through Renal Tubular Transport
Based on limited data in animals, not excreted through renal tubular transport.   Pharmacokinetic interaction unlikely. 
Nephrotoxic Agents
Potential pharmacologic interaction (increased risk of renal toxicity).      Assess patients taking concomitant nephrotoxic agents. (See Renal Effects under Cautions.)
Specific Drugs and Tests
Drug
Interaction
Comments
Bone-imaging agents
Potential to interfere with use of bone-imaging agents
Histamine H2-receptor antagonists
Increased oral bioavailability of ibandronate 
No evidence of increased adverse upper GI effects 
Not considered clinically important 
Melphalan
Pharmacokinetic interaction unlikely with IV ibandronate
NSAIAs
No evidence of increased adverse upper GI effects
Use concomitantly with caution
Prednisolone
Pharmacokinetic interaction unlikely with IV ibandronate
Tamoxifen
Pharmacokinetic interaction unlikely with IV ibandronate
 Ibandronate drug interactions (more detail)
