Key takeaways

  • As with other drugs, Boniva can cause side effects, such as jaw or teeth problems.
  • Most side effects may be mild and temporary, lasting a few days to weeks. In rare cases, side effects can be long term.
  • If side effects of Boniva become difficult to tolerate, talk with your doctor or pharmacist.

Boniva is used to treat and prevent osteoporosis after menopause.

Read on to learn about potential common, mild, and serious side effects.

Boniva has been discontinued

Boniva was removed from the market in 2023 and is no longer available.

While Boniva is no longer prescribed by healthcare professionals, a generic version called ibandronate oral tablet is available. The information about Boniva in this article also applies to ibandronate unless otherwise noted.

For more information about ibandronate, see the drug’s prescribing information.

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:

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:

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. Sharing your experience helps make medications safer for everyone by giving doctors and researchers more information about how the drug works in real life. If you develop a side effect while taking Boniva and want to tell the FDA about it, visit MedWatch or call 800-FDA-1088.

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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 include:

For more information about some of these side effects, see the “Managing side effects” section.

Allergic reaction

For some people, Boniva can cause an allergic reaction. Serious allergic reaction was rare in clinical studies.

In general, symptoms of allergic reaction can be mild or serious.

Ways to manage

For mild allergic reaction symptoms, such as a mild rash, call your doctor right away. They may recommend treatments to help manage your symptoms. They’ll also let you know whether you should keep taking the medication.

For severe allergic reaction symptoms, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms require immediate medical care because they can become life threatening. If you’ve had a serious allergic reaction to Boniva, your doctor may recommend taking a different medication instead.

Boniva may cause several side effects. Here are some frequently asked questions about the drug’s side effects and their answers.

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.

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:

• esophagus problems
• broken thigh bone
• problems with your jaws and teeth

For more information about these side effects, see “Managing side effects”.

If you have side effects that seem long term or become bothersome or severe, talk with your doctor or pharmacist.

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.

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.

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
• constipation
• diarrhea
• headache
• indigestion
• nausea

Boniva and Fosamax may also cause different side effects. Talk with your doctor if you have questions about side effects of these medications.

While taking Boniva, you may be able to take steps to make side effects easier to manage.

If you have problems with side effects that do not go away or they become worse, talk with your doctor or pharmacist. They can discuss options for managing side effects or other available treatment options.

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:

Symptoms of osteonecrosis can include:

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.

Esophagus problems

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:

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.

Before taking Boniva, discuss your health history with your doctor. Boniva may not be right for you if you have certain medical conditions or other factors affecting your health. Be sure to talk with your doctor if any of the following apply to you:

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.

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.