Get emergency medical help if you have signs of an allergic reaction to Boniva: hives; wheezing, difficult breathing; swelling of your face, lips, tongue, or throat.
Stop using this medicine and call your doctor at once if you have:
chest pain, new or worsening heartburn;
difficulty or pain when swallowing;
pain or burning under the ribs or in the back;
severe heartburn, burning pain in your upper stomach, or coughing up blood;
new or unusual pain in your thigh or hip;
jaw pain, numbness, or swelling;
severe joint, bone, or muscle pain; or
low calcium levels - muscle spasms or contractions, numbness or tingly feeling (around your mouth, or in your fingers and toes).
Common Boniva side effects may include:
heartburn, stomach pain, diarrhea;
back pain, bone pain, muscle or joint pain;
pain in your arms or legs;
headache; or
fever, chills, tiredness, flu-like symptoms.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
 Boniva side effects (more detail)
Before taking this medicine
You should not use Boniva if you are allergic to ibandronate, or if you have:
severe kidney disease; or
low blood levels of calcium (hypocalcemia).
Do not take an Boniva tablet if you have problems with your esophagus, or if you cannot sit upright or stand for at least 60 minutes. Ibandronate can cause serious problems in the stomach or esophagus. You must stay upright for at least 1 full hour after taking this medicine.
To make sure this medicine is safe for you, tell your doctor if you have ever had:
trouble swallowing;
problems with your stomach or digestion;
hypocalcemia;
a dental problem (you may need a dental exam before you begin using Boniva);
kidney disease; or
any condition that makes it hard for your body to absorb nutrients from food (malabsorption).
In rare cases, this medicine may cause bone loss (osteonecrosis) in the jaw. Symptoms include jaw pain or numbness, red or swollen gums, loose teeth, or slow healing after dental work. The longer you use Boniva, the more likely you are to develop this condition.
Osteonecrosis of the jaw may be more likely if you have cancer or received chemotherapy, radiation, or steroids. Other risk factors include blood clotting disorders, anemia (low red blood cells), and a pre existing dental problem.
Talk with your doctor about the risks and benefits of using this medication.
It is not known whether ibandronate will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.
It is not known whether ibandronate passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.
How should I use Boniva?
Use Boniva exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.
Boniva tablets are taken once per month. The injection is given into a vein through an IV once every 3 months. The tablets can be taken at home, but a healthcare provider must give the injection.
Take the tablet first thing in the morning, at least 60 minutes before you eat or drink anything or take any other medicine. Take the medicine on the same day each month and always first thing in the morning.
Take the tablet with a full glass (6 to 8 ounces) of plain water. Do not use coffee, tea, soda, juice, or mineral water. Do not eat or drink anything other than plain water.
Do not crush, chew, or suck on a tablet. Swallow it whole.
For at least 60 minutes (1 full hour) after taking a tablet:
Do not lie down or recline.
Do not take any other medicine including vitamins, calcium, or antacids.
Pay special attention to your dental hygiene while using Boniva. Brush and floss your teeth regularly. If you need to have any dental work (especially surgery), tell the dentist ahead of time that you are using this medicine.
Boniva is only part of a complete program of treatment that may also include diet changes, exercise, bone mineral density testing, and taking calcium and vitamin supplements. Follow your doctor's instructions very closely.
Store at room temperature away from moisture and heat.
Your doctor will determine how long to treat you with this medicine. Ibandronate is often given for only 3 to 5 years.
