Cidofovir
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Drug reference
ibandronate
Bisphosphonate (nitrogen-containing) · Antiresorptive agent
START
Osteoporosis: 150 mg PO monthly on empty stomach with full glass of water, remain upright ≥60 min; or 3 mg IV q3m
TYPICAL MAX
6 mg IV every 3–4 weeks (oncology)
STOP IF
ONJ, atypical femoral pain, severe oesophagitis, or hypocalcaemia
WATCH
Calcium / vitamin D status, renal function, oral health, oesophageal symptoms
CDSCO approvedATC M05BA06
KDIGO 2024 + manufacturer label
- ONSET
- 1h · absorption
- PEAK
- 1.5h · Tmax
- t½
- 1.5d · plasma t½
- DURATION
- 4.3w · monthly cover
EXCRETION
Renal — unchanged
route + CYP
INTERACTIONS
12 major
SEVERE in our sources
PREGNANCY
Avoid; limited data (fetal bone effects).
FDA category + note
Top interactionssee all 12 →
- CidofovirSevereDatabaseDDInter
- DeferasiroxSevereDatabaseDDInter
- DiatrizoateSevereDatabaseDDInter
- EtelcalcetideSevereDatabaseDDInter
Mechanism
Nitrogen-containing bisphosphonate that binds hydroxyapatite in bone and inhibits osteoclast farnesyl pyrophosphate synthase, reducing osteoclast-mediated bone resorption — increases bone mineral density and reduces vertebral fracture risk.
Indications
Postmenopausal osteoporosis (treatment and prevention)Skeletal events of metastatic breast cancer (with bone metastases)
Dosing
- Adult
- Osteoporosis: 150 mg PO once monthly OR 3 mg IV every 3 months. Metastatic bone disease: 6 mg IV over 15 min every 3–4 weeks.
- Pediatric
- Not established.
- Renal adjustment
- CrCl <30: not recommended.
- Hepatic adjustment
- No adjustment.
- Geriatric
- No specific adjustment.
- Max dose
- 6 mg IV every 3–4 weeks (oncology) or 150 mg PO monthly (osteoporosis)
Pharmacokinetics
Onset
Bone-resorption inhibition over days; BMD effect over months
Peak effect
~0.5–2 h (oral Tmax) / end of infusion (IV)
Duration
Bone t½ years (very long retention)
Half-life
Plasma 10–60 h; bone retention >10 years
Bioavailability
~0.6% oral (must fast)
Protein binding
~85–99%
Metabolism
Not metabolised
Excretion
Renal — unchanged
Contraindications
- Hypocalcaemia
- Severe renal impairment (CrCl <30)
- Inability to sit/stand upright for ≥60 min (oral)
- Achalasia / oesophageal stricture (oral)
- Hypersensitivity
Side effects
Common
Dyspepsia / oesophagitis (oral)Acute-phase reaction (flu-like, IV)HeadacheMusculoskeletal painHypocalcaemia
Serious
- Osteonecrosis of the jaw (especially IV/oncology dosing)
- Atypical femoral fractures
- Severe oesophagitis / oesophageal ulcer
- Severe hypocalcaemia
- Renal toxicity (IV, rapid infusion)
Pregnancy & lactation
Pregnancy
Avoid; limited data (fetal bone effects).
Lactation
Avoid; minimal absorption to infant but caution.
Drug interactions
Deferasirox
Severe
Database
Clinical effect not specified
Source: DDInter
Diatrizoate
Severe
Database
Clinical effect not specified
Source: DDInter
Etelcalcetide
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Human Cytomegalovirus Immune Globulin
Severe
Database
Clinical effect not specified
Source: DDInter
Inotersen
Severe
Database
Clinical effect not specified
Source: DDInter
Iodipamide
Severe
Database
Clinical effect not specified
Source: DDInter
Iodixanol
Severe
Database
Clinical effect not specified
Source: DDInter
Iohexol
Severe
Database
Clinical effect not specified
Source: DDInter
Iopamidol
Severe
Database
Clinical effect not specified
Source: DDInter
Iopromide
Severe
Database
Clinical effect not specified
Source: DDInter
Iothalamic Acid
Severe
Database
Clinical effect not specified
Source: DDInter
Related guidelines
Ask House about ibandronate
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: Goodman & Gilman 14e·Verified: 2026-05-20 · House clinical team·Cockpit curated: 2026-05-20