Boniva is one of three FDA approved drugs for the treatment of osteoporosis. Like Fosamax and Actinol, Boniva is a bisphosphonate. Unlike Fosamax and Actinol, which are taken weekly, Boniva is taken only once a month.
Bone Formation
Bone is a living tissue that is constantly being created and broken down over one's lifetime. Cells called osteoclasts constantly break down and resorb bone tissue and cells called osteoblasts rebuild bone. When the rate of bone resorbtion is greater than bone rebuilding, there is a net loss of bone mineral density and the bones start to thin, increasing the risk of fractures.
Osteoporosis
Osteoporosis is a bone disease characterized by a decrease in bone density leading to a greater risk of fracture. Typically, bone material density increases until early adulthood--around age 30 in women--and remains stable until menopause when there is a decline associated with the loss of estrogen. Men are also at risk for osteoporosis but comprise only 20 percent of cases.
Treatment
Broadly, the management of osteoporosis consists of three strategies: blocking continued loss of bone material density, increasing bone density, and preventing falls and the risk of fractures.
Boniva, Fosamax, and Actinol are prescription drugs for the treatment of osteoporosis. All three are bisphosphonates, the most common category of drugs given to treat osteoporosis.
Bisphosphonates work by permanently lining the surface of bone, preventing attachment by the osteoclasts. Osteoclasts are then unable to break down bone and continued bone loss is blocked or slowed.
Boniva
Boniva is the commercial name for ibandronate sodium. Boniva and the other bisphosphonates differ somewhat in chemical composition in ways that affect their effectiveness in binding to bone and their interference with bone resporbtion.
Boniva has been clinically tested against Fosamax, or alendronate, another bisphosphonate, to compare their effectiveness in preventing bone loss. According to an extensive review conducted by Provider Synergies for Oregon's Office for Health Policy and Research, once monthly Boniva is comparable to once weekly Fosamax in preventing bone loss of the hip or spine over a 12-month period.
Calcium and Vitamin D
Often calcium and Vitamin D are also prescribed to increase the buildup of bone material density. Calcium is one of the main mineral components of bone and also inhibits resorbtion of bone, decreasing bone turnover. Vitamin D is necessary for normal bone formation.
The Institute of Medicine has recommended that adults have a total daily calcium intake of 1,200 mg of elemental calcium.
Side Effects
The most commonly reported side effects of bisphosponates, including Boniva, are gastrointestinal. The instructions advise users to enhance absorption and minimize gastrointestinal adverse events by taking the medication with a full glass of water, remaining upright after taking the oral medication, and refraining from eating for 30 to 60 minutes.
References
- Boniva.com
- Provider Synergies: Bone Resorption Suppression and Related Agents Review
- "American Journal of Managed Care"; An Integrated Approach: Bisphosphonate Management for the Treatment of Osteoporosis; Gary Owens, M Rebecca Jackson and E. Michael Lewiecki: 2007.
- "Recommended Dietary Allowances"; Institute of Medicine; 1997
