Boniva (ibandronate) is a brand-name oral tablet that’s prescribed to help prevent and treat osteoporosis. As with other drugs, Boniva can cause side effects, such as jaw or teeth problems. In rare cases, side effects can be long term.
Boniva is used in females who have gone through menopause. It may be taken long term for osteoporosis. If your doctor determines that your risk of bone fracture is low, they may recommend that you stop taking Boniva after 3 to 5 years of treatment. This is because the safety and effectiveness of Boniva, when taken for longer than 3 years, isn’t known.
Boniva belongs to the bisphosphonate drug class. Boniva tablets come in a strength of 150 milligrams (mg).
Read on to learn about potential common, mild, and serious side effects. For a general overview of Boniva, including details about its uses, see this article.
Note: Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.
Boniva can cause certain side effects, some of which are more common than others. These side effects may be temporary, lasting a few days to weeks. But if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.
These are just a few of the more common side effects reported by people who took Boniva in clinical studies:
- back pain
- pain in your arms and legs
Mild side effects can occur while taking Boniva. This list doesn’t include all possible mild side effects of the drug. For more information, you can refer to Boniva’s prescribing information.
Mild side effects that have been reported with Boniva include:
- abdominal pain
- back pain
- bronchitis (a type of lung infection)
- flu-like symptoms, including chills, fever, and fatigue
- muscle pain
- pain in your arms and legs
These side effects may be temporary, lasting a few days to weeks. But if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.
Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you develop a side effect while taking Boniva and want to tell the FDA about it, visit MedWatch.
Boniva may cause serious side effects. The list below may not include all possible serious side effects of the drug. For more information, you can refer to Boniva’s prescribing information.
If you develop serious side effects while taking Boniva, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.
Serious side effects that have been reported and their symptoms include:
- Kidney problems, such as acute kidney failure. Symptoms can include:
- urinating less frequently than usual
- Low calcium levels. Symptoms can include:
- “pins and needles” feeling in your arms or legs
- problems with memory
- Problems with your jaws and teeth.*
- Broken thigh bone.*
- Severe bone, joint, or muscle pain.*
- Esophagus problems.*
- Allergic reaction.*
* For more information about this side effect, see the “side effect specifics” section above.
Boniva may cause several side effects. Here are some frequently asked questions about the drug’s side effects and their answers.
Is weight gain a side effect of Boniva?
No, weight gain isn’t a known side effect of Boniva. People taking Boniva in clinical studies didn’t report weight gain as a side effect.
Weight gain may occur during menopause. And since Boniva is approved for use after menopause, you may gain weight during this time.
If you’re concerned about your weight while taking Boniva, talk with your doctor. They can recommend tips on how you can maintain a moderate weight.
How long do Boniva’s side effects last? Are any long term?
Most side effects of Boniva are temporary, lasting a few days to weeks.
However, in rare cases, Boniva can cause side effects that are long in duration. Long-term side effects may include:
For more information about these side effects, see “Side effect specifics” below.
If you have side effects that seem long term or become bothersome or severe, talk with your doctor or pharmacist.
Is Boniva available as an infusion? If so, what are the side effects of this form?
No, brand-name Boniva isn’t available as an infusion (an injection into your vein that’s given over a period of time). This form of Boniva was previously available in the United States, but it’s no longer on the market.
Ibandronate (the generic form of Boniva) is available as an injection. To learn more about ibandronate, including its forms and side effects, talk with your doctor or pharmacist.
Does Boniva cause hair loss?
No, hair loss isn’t a known side effect of Boniva. People taking Boniva in clinical studies didn’t report hair loss as a side effect.
Hair loss may be a side effect of other drugs that treat osteoporosis or other drugs that treat symptoms of menopause. Hair loss can also occur during menopause.
If you are concerned about hair loss due to Boniva or other drugs, talk with your doctor or pharmacist.
What are the side effects of Boniva vs. Fosamax?
Boniva and Fosamax (alendronate) are osteoporosis drugs that have some similar side effects. This is because they belong to the same drug class: bisphosphonates.
Some side effects that both Boniva and Fosamax have in common include:
- abdominal pain
Boniva and Fosamax may also cause different side effects. To learn more about the similarities and differences of these drugs, including their side effects, check out this article.
Learn more about some of the side effects that Boniva may cause.
Problems with your jaws and teeth
Boniva may cause problems with your jaws and teeth. This was a rare side effect in clinical studies. Specifically, Boniva may cause a rare but serious problem called osteonecrosis. With osteonecrosis, there isn’t enough blood flowing to your bones. This causes damage to your bones, including in your jaws and teeth.
Problems with your jaws and teeth may occur at any time while you’re taking Boniva. Certain people may be at higher risk, including people with:
- anemia (low red blood cell levels)
- certain dental problems, such as dentures that don’t fit well
- recent dental work, including dental implants or tooth removal
- poor oral health
Symptoms of osteonecrosis can include:
- loose teeth
- pain or discomfort in your jaw
- sores in your mouth
What you can do
Before you begin taking Boniva, your doctor will examine your mouth. They may advise you to see a dentist before you start taking Boniva. While taking Boniva, it’s very important to practice good oral hygiene to help lower your risk for jaw and teeth problems. This includes brushing your teeth and flossing daily.
If you notice any symptoms of osteonecrosis while taking Boniva, talk with your doctor or dentist.
Broken thigh bone
Taking Boniva can increase the risk of broken thigh bones. But this was a rare side effect in clinical studies.
A broken thigh bone can happen in either leg and may occur with only a light force.
Symptoms of a broken thigh bone can include new or unusual pain in your groin, hip, or thigh. You may also feel a dull ache in your thigh area for several weeks before the bone breaks.
What you can do
Tell your doctor right away if you have thigh pain while taking Boniva. They may perform tests to check for a broken thigh bone. If you have a broken thigh bone, they’ll likely recommend you stop taking Boniva until the bone heals. Or your doctor may have you stop taking Boniva long term. They may recommend a different treatment for your condition.
Severe bone, joint, or muscle pain
Boniva can cause pain in bones, joints, or muscles. In rare cases, this pain may be severe.
Severe bone, joint, or muscle pain has been reported as soon as 1 day after starting Boniva. This side effect has also happened months after people took their first dose.
What you can do
If you have severe bone, joint, or muscle pain at any time while taking Boniva, talk with your doctor. These symptoms usually go away once you stop taking Boniva. So, your doctor will likely recommend you stop taking the medication. They can discuss other treatment options for your condition with you.
Bisphosphonate drugs, such as Boniva, are known to cause esophagus problems. (The esophagus is the tube that connects the mouth and stomach.) This is because these medications can irritate this area if you don’t take Boniva correctly. Be sure to follow your doctor’s instructions on how to take Boniva.
In rare instances, bisphosphonates, including Boniva, have caused esophagus problems, including:
- esophagitis (inflammation of the esophagus)
- ulcers (sores in the lining of the esophagus)
- wearing away of the esophagus
- tightening of the esophagus
- hole in the esophagus
Although not common, these complications can be severe and require treatment in the hospital.
Symptoms of esophagus problems can include chest pain, new or worsening heartburn, difficulty swallowing, or pain while swallowing. They may also include food getting stuck in your throat or loss of appetite.
What you can do
To avoid developing esophagus problems, be sure to take your dose correctly.
Below are some important dosing instructions on how to take Boniva:
- Avoid eating and drinking anything except water for at least 1 hour before and 1 hour after taking Boniva. You should also avoid taking other medications during these times.
- Take each Boniva dose with a full glass (6 to 8 ounces) of water.
- Take Boniva while sitting or standing up. And avoid lying down for at least 1 hour after taking your dose.
If you have symptoms of esophageal problems, stop taking Boniva and tell your doctor right away. To learn more about how to take Boniva, talk with your doctor or pharmacist or see this article.
As with most drugs, Boniva can cause an allergic reaction in some people. Serious allergic reaction was rare in clinical studies.
Symptoms can be mild or serious and can include:
- skin rash
- swelling under your skin, typically in your lips, eyelids, feet, or hands
- swelling of your mouth, tongue, or throat, which can make it hard to breathe
What you can do
For mild symptoms of an allergic reaction, call your doctor right away. They may recommend ways to ease your symptoms and determine whether you should keep taking Boniva. But if your symptoms are serious and you think you’re having a medical emergency, immediately call 911 or your local emergency number.
Be sure to talk with your doctor about your health history before you take Boniva. This drug may not be right for you if you have certain medical conditions or other factors that affect your health. The conditions and factors to consider include:
Scheduled dental work. Having certain dental work done while you’re taking Boniva can increase your risk for osteonecrosis in your jaw and teeth. Talk with your doctor if you plan to have dental surgery or any teeth removed while taking Boniva. They may have you temporarily stop taking Boniva to lower your risk for osteonecrosis.
Esophagus problems. If you have problems with your esophagus, such as difficulty swallowing, it’s important to tell your doctor before taking Boniva. The drug can cause esophagus problems* as a side effect. Boniva can also worsen existing esophagus problems. Due to this risk, doctors typically will not prescribe the drug if you have certain esophagus problems. Your doctor can determine if Boniva is safe for you to take.
Severe kidney problems. Your body uses your kidneys to get rid of Boniva after you take a dose. If you have severe kidney problems, your doctor will not usually prescribe Boniva. This is because your body may not be able to get rid of the medication properly. Your doctor can determine if Boniva is safe for you to take.
Low blood calcium or vitamin D levels. Having low calcium or low vitamin D levels in your blood could increase your risk for broken bones. Boniva can also decrease calcium levels as a side effect. Your doctor will check your calcium level before you start taking Boniva. If it’s low, they will likely recommend bringing your levels back to normal before starting Boniva. This may include taking vitamin D and calcium supplements.
Problems absorbing nutrients. Some conditions, such as celiac disease and lactose intolerance, can prevent your body from absorbing nutrients, such as calcium. This can increase your risk for side effects* from taking Boniva. If you have these conditions, your doctor can determine if Boniva is safe for you to take.
Unable to sit or stand up for at least 60 minutes. You should remain sitting or standing up for at least 60 minutes after each Boniva dose. This helps lower your risk for esophagus problems from the drug. Your doctor will likely recommend a different medication if you’re unable to sit or stand up for at least 60 minutes after taking Boniva.
Allergic reaction. If you’ve ever had an allergic reaction* to Boniva or any of its ingredients, your doctor will likely not prescribe Boniva. Talk with your doctor about which other treatments may be better options for you.
* For more information, see the “Side effect specifics” section above.
Alcohol with Boniva
There aren’t any known interactions between drinking alcohol and taking Boniva. If you drink alcohol, talk with your doctor about how much is safe for you to consume while you’re taking Boniva.
Pregnancy and breastfeeding while taking Boniva
Boniva hasn’t been studied in pregnant people. The drug also hasn’t been studied in people who are breastfeeding. Boniva is approved to help prevent and treat osteoporosis only in females* who have gone through menopause.
Talk with your doctor if you have questions about taking Boniva while pregnant or breastfeeding. You should also talk with your doctor if you’re thinking about becoming pregnant or are considering breastfeeding.
* Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.
Side effects can occur while taking Boniva, but they’re usually mild. Most mild side effects of the drug go away with time and don’t require medical attention. But if the side effects last a long time or become bothersome or severe, be sure to talk with your doctor.
If you’d like to learn more about Boniva, talk with your doctor or pharmacist. They can help answer any questions you have about side effects from taking the drug.
Besides talking with your doctor, you can do some research on your own. These articles might help:
- More information about Boniva. For details about other aspects of Boniva, refer to this article.
- A look at your condition. For details about osteoporosis after menopause, see our list of osteoporosis articles and menopause articles. Our women’s health hub may also be helpful.
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.