Boniva vs Prolia - Comparison of Side Effects & Uses

Boniva

It is the brand name of a drug called ibandronate, the first-choice treatment for osteoporosis. It’s also only approved for women, not men.

The medication works by increasing bone thickness and preventing the breakdown of bones. It belongs to a class of drugs known as bisphosphonates. This class of medications also includes Alendronate (Fosamax).

The US FDA originally approved it in May 2003.

Uses

This medication is used to treat or prevent osteoporosis in women after menopause. Osteoporosis is a bone disease which occurs when the body makes too little bone, loses too much bone, or both.

The chances of developing this bone condition increase after menopause or if you take corticosteroid medications for long periods of time. Common causes of osteoporosis include:

  • smoking tobacco or regular exposure to tobacco smoke;
  • certain diseases;
  • alcohol abuse;
  • sedentarism;
  • a diet high in saturated- and trans-fats.

Dosage

The usual recommended dose is 3 mg by IV injection over 15 to 30 seconds every 90 days. The usual recommended oral dose is 150 mg once a month.

Notes – the tablet should be taken on the same day of each month. Do not take any other medicines including calcium supplements, vitamins, or antacids for at least one hour before or after taking this bisphosphonate.

Side Effects and Precautions

Common side effects may include:

  • diarrhea;
  • headaches;
  • flu symptoms;
  • back pain;
  • upset stomach;
  • pain in the arms or legs;
  • nausea;
  • swelling or redness where the medication was injected;
  • redness of the eyes.

Rare side effects may include:

  • new or worsening heartburn;
  • chest pain;
  • muscle pain;
  • jaw numbness, pain, or swelling;
  • unusual pain in the thigh or hip;
  • pain under the ribs or in the back;
  • difficulty or pain when swallowing.

To make sure that this bisphosphonate is safe for you, tell your healthcare provider if you have ever had:

  • problems with the stomach or digestion;
  • trouble swallowing;
  • kidney disease;
  • hypocalcemia;
  • any condition which makes it hard for your body to absorb nutrients from food;
  • a dental problem.

Alcohol

Avoid drinking large amounts of alcoholic beverages while taking this bisphosphonate since it increases the risk of side effects.

Pregnancy & Breastfeeding

It is not known exactly whether this bisphosphonate passes into breast milk and negatively affects the infant, hence, talk to your healthcare provider if you are taking this medication and plan on breastfeeding a baby.

Additionally, it’s not known precisely whether this bisphosphonate can harm an unborn baby. Therefore, talk to your healthcare provider if you are pregnant or might fall pregnant while taking this medication.

Drug Interactions

This bisphosphonate may negatively interact with other medications, especially:

  • diclofenac (Voltaren);
  • celecoxib (Celebrex);
  • ketoprofen (Orudis);
  • diflunisal (Dolobid);
  • dulera;
  • piroxicam (Feldene);
  • ibuprofen (Motrin, Advil);
  • naproxen (Aleve, Naprosyn);
  • ketorolac (Toradol);
  • buspar;
  • indomethacin (Indocin).

Prolia

It is the brand name of a drug called denosumab, that belongs to a family of drugs known as monoclonal antibodies. It works by reducing the amount of bone the human body breaks down, hence, making the bones less likely to break.

Uses

This medication is used:

  • for the treatment of postmenopausal women with osteoporosis at high risk for fracture;
  • to increase bone mass in men at high risk for fracture receiving androgen deprivation therapy;
  • to increase bone mass in women at high risk for fracture receiving adjuvant aromatase inhibitor therapy.

Dosage

This monoclonal antibody comes in an injectable form to be given under the skin and is given once every 6 months.

Side Effects and Precautions

Common side effects may include:

  • muscle pain;
  • bladder infection (painful or difficult urination);
  • pain in the arms or legs;
  • back pain.

Rare side effects may include:

  • severe pain in the muscles, joints, or bones;
  • unusual pain in your hip, thigh, or groin;
  • a tingly feeling in the mouth or in the fingers or toes;
  • skin peeling, dryness, redness, itching, or crusting;
  • overactive reflexes;
  • feeling short of breath;
  • chills, fever, night sweats;
  • muscle tightness or contraction;
  • burning when you urinate;
  • redness anywhere on the body;
  • severe stomach pain;
  • an urgent need to urinate.

To make sure that this monoclonal antibody is safe for you, tell your healthcare provider if you have:

  • a history of thyroid surgery;
  • if you are on dialysis;
  • kidney disease;
  • a history of surgery to remove part of the intestines;
  • a weak immune system;
  • if you are allergic to latex;
  • any condition which makes it hard for the body to absorb nutrients from food;
  • a history of hypoparathyroidism.

Pregnancy & Breastfeeding

It is not known exactly if this monoclonal antibody crosses into human milk and negatively affects the infant. Therefore, talk to your healthcare provider and then decide if the benefits outweigh the risks of using this medication.

More importantly, this medication falls into category X. This means that it has been shown that women taking this monoclonal antibody during pregnancy may have babies born with problems.

Bottom Line – Boniva vs Prolia

Boniva (active ingredient – ibandronate) is a medication that belongs to a class of medications known as bisphosphonates. The medication works by preventing the breakdown of bones and is used to prevent and treat osteoporosis in women who have been through menopause.

Note – according to studies, it has been shown to reduce the risk of spinal fractures by an estimated 50 percent over three years, however, it hasn’t shown to be effective in reducing other fractures, like – wrist or hip.

Prolia (active ingredient – denosumab) is a medication that is used to treat bone loss in patients receiving certain treatments for prostate cancer as well as to treat osteoporosis. It can be found only as a subcutaneous injection.

References

https://www.ncbi.nlm.nih.gov/pubmed/28546097
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2898002/
http://www.nejm.org/doi/full/10.1056/NEJMoa0809493

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