Bonviva Tablet 150mg contains the active ingredient ibandronic acid, which is a type of medicine called a bisphosphonate and it is used in the treatment of osteoporosis in menopausal women, as they are at a much higher risk of bone fractures. The ibandronic acid works by binding very tightly to the bone and prevents the loss of calcium. It also works to prevent the bone from breaking down to keep it strong and less likely to break or fracture.

Osteoporosis is a condition where bone strength is reduced and the chance of bone fractures could therefore be increased. The menopause greatly increases a woman’s chance of developing osteoporosis, as it causes a drop in the hormone estrogen, which is known for protecting the bones. The drop is estrogen at this stage of life then leads to bone loss, weakening of bones and a higher risk of fractures. Bone loss is particularly rapid for the first 10 years after the onset of the menopause and it can easily lead to the development of osteoporosis. There is therefore a well-established link between osteoporosis and the menopause, which is why this particular medicine is specifically tailored to strengthening bones in menopausal women. 

Directions for taking Bonviva Tablet 150mg:

• It is very important that the instructions for taking Bonviva tablets are followed completely. This is because when ibandronic acid is taken by mouth it can cause irritation and ulceration of the foodpipe (oesophagus). Following the instructions below minimises this risk. If you are unclear about anything ask your pharmacist for advice.
• Your Bonviva tablet should be taken on the same date each month, in the morning after an overnight fast (at least six hours) and before the first food, drink or medicine of the day.
• The tablet should be swallowed whole with a glass of plain water (180 to 240ml, not mineral water) while you are sitting or standing in an upright position. Do not crush, chew or suck the tablet.
• You should not lie down for one hour after taking your Bonviva tablet.
• You should not eat or drink anything other than plain water for one hour after taking the tablet. This is because food and some drinks (including mineral water) can interfere with the absorption of the medicine from the gut and hence make it less effective.
• You should not take any other medicine by mouth in the six hours before you take your Bonviva tablet, at the same time as your Bonviva tablet, or in the hour after you have taken the tablet. See the end of this factsheet for more details.
• If you forget to take your monthly tablet, you should take it the morning after you remember, and then return to taking it once a month on your normal date. However, if you miss a dose but realise that your next dose is due in the next seven days, forget the missed dose and take your next scheduled dose on the day you would normally take it. You should not take two tablets within the same week. You may find it helpful to keep a reminder, eg on a calendar, of what date you have taken your tablet and what date your next dose is due.

Caution before taking Bonviva Tablet 150mg:

• If you experience any signs of irritation to your foodpipe during treatment with this medicine, for example new or worsening problems with swallowing, pain on swallowing, pain behind your breastbone, or heartburn, you should stop taking Bonviva tablets and inform your doctor.
• Your doctor may want you to have regular blood tests to monitor your kidney function and the level of calcium in your blood while you are having treatment with this medicine.
• The class of medicines that ibandronic acid belongs to (bisphosphonates) has been associated with a rare condition called osteonecrosis of the jaw. The majority of cases of this condition have been in cancer patients treated with bisphosphonates by injection into a vein, and many of these people were also having treatment with chemotherapy or corticosteroids. However, the condition has also been seen in people taking bisphosphonates by mouth. The risk may also be increased by poor oral hygiene, dental problems such as gum disease or poorly fitting dentures, teeth extractions, oral surgery and smoking. For this reason, you should have a dental examination and, if necessary, appropriate preventive dentistry, before you start treatment with this medicine. Discuss this with your doctor. It is important to look after your mouth and teeth as much as possible while you are taking this medicine. You should have regular check-ups with your dentist and get advice straight away if you have any problems with your mouth or teeth. When you see a dentist during treatment, make sure they know you are taking this medicine. Invasive dental procedures such as tooth extraction or surgery should be avoided if possible.
• Some people being treated with bisphosphonates (mainly people having long-term treatment for osteoporosis) have experienced an unusual fracture of their thigh bone. For this reason it is important to let your doctor know if you get any pain in your thighs, hips or groin while you are having treatment with this medicine. These symptoms could be an early indication of a possible fracture.

Use with caution in:

• Decreased kidney function
• Disorders of the parathyroid gland (gland that produces hormones responsible for regulating calcium metabolism)
• Vitamin D deficiency
• Bonviva tablets should be used with caution in people with active disorders of the upper part of the digestive system, such as difficulty swallowing, disorders affecting the foodpipe (eg reflux disease), ulcers, inflammation of the lining of the stomach (gastritis), inflammation of the small intestine (duodenitis)

Not to be used in:

• Children
• Pregnancy
• Breastfeeding
• People who have a low level of calcium in their blood (hypocalcaemia)
• Bonviva tablets should not be used in people who have any abnormality of the foodpipe (oesophagus) that causes difficulty swallowing or delayed passage of food through the foodpipe, eg narrowing or achalasia of the foodpipe
• Bonviva tablets should not be used in people who cannot stand or sit upright for at least 60 minutes
• Bonviva tablets contain lactose and should not be taken people with rare hereditary problems of galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption
• Allergies or sensitivity to any of the medicine’s ingredients