Brand Names:

Boniva

What is it?

Ibandronate is normally used to treat or prevent osteoporosis (thinning of the bone). The drug binds to the bones in the body and prevents them from breaking down

What’s In It For Me?

Thin bones can easily break or fracture. Alendronate sodium prevents bones from
thinning and strengthens bones that are already weak. This medication is usually
taken only once a week and can reduce your chances of having a bone break or
fracture by about a third. See our Osteoporosis page for more information.

The Good

This medication can be given once per month  It has not yet been proven to decrease the risk of fractures in women who are at high risk.  It is similar to Alendronate and Risedronate and it PROBABLY will work the same way.   

The Bad

You must be able to stand or sit upright for 30 minutes after taking ibandronate. The tablet needs to be taken with a full glass of water at least a half hour (preferably 2 hours) before the first food of the day. The most common side effects are upset stomach, constipation or diarrhea, but the worrisome one is ulcers in the esophagus. Fortunately, that occurs in less than 1% of people taking it.   Approximately 3% of people taking alendronate sodium experience muscle or bone pain.

The Controversial

Bone strength is often estimated by measuring a person’s bone mineral density (BMD). This
will determine if you have osteoporosis or not. We believe that ibandronate should only be prescribed after a person is diagnosed with osteoporosis and should not be used for prevention of osteoporosis.
In fact, we only recommend alendronate for patients who have a high of a fracture in the next 10 years. You can calculate your risk by using this FRAX calculator provided by the World Health Organization. Select your country and ethnicity first under calculation tools and then fill out the form. See our Osteoporosis Page for specific tratment recommendations for you.

Fact Boxes

There are not enough studies to provide a fact box for Ibandronate yet. You can look at Alendronate or Risedronate to get an idea.

For The Cynic

If you do not have osteoporosis, do not bother with taking ibandronate. The small advantage of the monthly dose is tiny compared to the lack of fracture evidence and the extremely high cost.

The Cost

Ibandronate is extremely expensive.

Ibandronate increases bone density. We prefer Alendronate due to the evidence of fracture prevention and the lower cost.

Brand Names:

Actonel, Atelvia

What is it?

Risedronate is normally used to treat or prevent osteoporosis (thinning of the bone). The drug binds to the bones in the body and prevents them from breaking down

What’s In It For Me?

Thin bones can easily break or fracture. Alendronate sodium prevents bones from
thinning and strengthens bones that are already weak. This medication is usually
taken only once a week and can reduce your chances of having a bone break or
fracture by about a third. See our Osteoporosis page for more information.

The Good

This medication is usually taken only once per week. It has been proven to decrease the risk of fractures in women who are at high risk.  It is probably equal to Alendronate in benefit, but it has not been proven in as many different situations and Alendronate is cheaper, although they should be the same price in a year or two.

The Bad

You must be able to stand or sit upright for 30 minutes after taking alendronate sodium. The tablet needs to be taken with a full glass of water at least a half hour (preferably 2 hours) before the first food of the day. The most common side effects are upset stomach, constipation or diarrhea. Approximately 3% of people taking alendronate sodium experience muscle or bone pain.

The Controversial

Bone strength is often estimated by measuring a person’s bone mineral density (BMD). This
will determine if you have osteoporosis or not. We believe that alendronate sodium should only be prescribed after a person is diagnosed with osteoporosis and should not be used for prevention of osteoporosis.
In fact, we only recommend alendronate for patients who have a high of a fracture in the next 10 years. You can calculate your risk by using this FRAX calculator provided by the World Health Organization. Select your country and ethnicity first under calculation tools and then fill out the form. See our Osteoporosis Page for specific tratment recommendations for you.

Fact Boxes

For The Cynic

If you do not have osteoporosis, do not bother with taking risedronate. This medication reduces the risk of clinical fractures in women with osteoporosis but not in women with higher bone mineral density (BMD).  Risedronate can decrease the risk of a major fracture by up to 6% in a patient with osteoporosis who have had a fracture. This means that if your risk of having a fracture is 20%, Risedronate may decrease your risk to 14%. In other words, with Risedronate your chances of NOT having a fracture would increase from 80% to 86%.

The Cost

Risedronate is scheduled to go generic in 2011, but the cost is still extremely high as of now.