Bonviva IV is used to treat or relieve symptoms of the following diseases: Osteoporosis, Bone Metastases, Hypercalcemia of Malignancy,
Ibandronate is used to treat or prevent osteoporosis in women after menopause.
Bonviva IV is a drug made in Hong Kong. You need a doctor's prescription to buy it. But its analogues can be bought online anywhere in the world without going to a specialist.
Ibandronate is a complete analogue of Bonviva IV. It has the same composition, dosage and methods of use. Also Ibandronate has a lower cost compared to Bonviva IV.
To buy Bonviva IV, click on the "buy now" button and then in our online store select the medicine and the desired dosage. Follow the instructions below.
Free delivery is valid for purchases from $200. We deliver medicines around the world and provide the best prices.
You can also use a coupon giving a 5% discount.
Get emergency medical help if you have even mild symptoms: new or unusual pain in your thigh or hip; chest pain, new or worsening heartburn; difficulty or pain when swallowing; severe joint, bone, or muscle pain; or severe heartburn, burning pain in your upper stomach, or coughing up blood; heartburn, stomach pain, diarrhea; headache; or pain in your arms or legs;
It is not known whether ibandronate will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.
It is not known whether ibandronate passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.
Deferasirox: Bisphosphonate Derivatives may enhance the adverse/toxic effect of Deferasirox. Specifically, the risk for GI ulceration/irritation or GI bleeding may be increased. Monitor therapy
Nonsteroidal Anti-Inflammatory Agents: May enhance the adverse/toxic effect of Bisphosphonate Derivatives. Both an increased risk of gastrointestinal ulceration and an increased risk of nephrotoxicity are of concern. Monitor therapy
Proton Pump Inhibitors: May diminish the therapeutic effect of Bisphosphonate Derivatives. Monitor therapy
Take on an empty stomach. All foods markedly reduce (up to 90%) ibandronate bioavailabilty. Take with plain water (not mineralized) at least 1 hour before any food. Bioavailability and effect on bone density are both impaired if the patient eats or drinks in less than 1 hour after taking this product. Drink a large glass of water and stay in an upright position for at least 60 minutes after taking this product.
Structure: 1 ml of infusion concentrate contains:
Active substance: ibandronic acid 1 mg (in the form of sodium ibandronate monohydrate 1.125 mg);
Excipients: sodium chloride - 8.600 mg, acetic acid 99% - 0.510 mg, sodium acetate trihydrate - 0.204 mg, water for injection.
Description: Transparent colorless liquid.for treating group: Bone resorption inhibitor bisphosphonate.
Bone resorption inhibitor, nitrogen-containing bisphosphonate. It has effectiveness specific selective effect on bone tissue due to its high affinity for the mineral components of the bone. It suppresses the activity of osteoclasts, reduces the frequency of skeletal complications in malignant diseases.
Ibandronic acid reduces the osteoclast-associated release of tumor growth factors, inhibits the spread and invasion of tumor cells, has a synergistic effect with taxanes in vitro. Ibandronic acid prevents bone destruction caused by blockade of the function of Bonviva gonads, retinoids, tumor processes or the introduction of extracts of tumor tissue in vivo.
In doses significantly higher than pharmacologically effective, ibandronic acid does not affect bone mineralization.
With hypercalcemia, the inhibitory effect of ibandronic acid on tumor-induced osteolysis and, in particular, on concomitant tumor process hypercalcemia is accompanied by a decrease in serum calcium and urinary calcium excretion. In most cases, the calcium level in the blood normalizes within 4-7 days after administration of the drug. Median time to re-increase serum albumin-corrected calcium to 3 mmol / L - 18-26 days.
Ibandronic acid prevents the development of new and reduces the growth of existing bone metastases, which leads to a decrease in the frequency of skeletal complications, the intensity of the pain syndrome, the need for radiation therapy and surgical interventions for the metastatic process in the bones, thereby leading to a significant improvement in the quality of life of patients.
Ibandronic acid dose-dependently inhibits tumor osteolysis, which is determined using bone resorption markers (pyridinoline and deoxypyridinoline).
After oral administration, ibandronic acid is rapidly absorbed in the upper gastrointestinal tract. The time to reach the maximum TCmax concentration of 0.5-2 h (median - 1 h) after fasting, the absolute bioavailability of 0.6%. The simultaneous intake of food or drinks (except for pure water) reduces the bioavailability of ibandronic acid by 90%. Eating food or drinks 30 minutes Enlon-Plus taking ibandronic acid reduces its bioavailability by 30%. When taking ibandronic acid 60 minutes before meals, a significant decrease in bioavailability is not observed.
The concentration of ibandronic acid in plasma increases in proportion to the dose administered intravenously (at a dose of up to 6 mg) or ingested (at a dose of up to 100 mg).
The bioavailability of ibandronic acid is reduced to 75% when it is taken 2 hours after a meal, and therefore it is recommended to take Bondronat ® in tablet form on an empty stomach with a subsequent meal no earlier than 30 minutes later.
After getting into the systemic circulation, ibandronic acid binds quickly in bone tissue or is excreted in the urine. The apparent final distribution volume is 90 l; the amount of the drug in the bone tissue, usually reaches 40-50% of the dose circulating in the blood. Communication with plasma proteins at therapeutic concentrations of the drug - 87%. Thus, the likelihood of inter-drug interactions due to displacement from communication with proteins is quite Bonviva.
There is no evidence that ibandronic acid is metabolized (both in humans and animals).
40-50% of the amount of the drug circulating in the blood penetrates the bone tissue and accumulates in it, the remaining drug is excreted unchanged by the kidneys. Non-absorbable preparation after oral administration is excreted unchanged with feces.
The magnitude of the observed apparent final half-life varies widely (10-60 h) and depends on the dose of the drug and the sensitivity of the analysis. The concentration of the drug in the blood decreases rapidly and reaches 10% of the maximum 3 hours after iv administration and 8 hours after oral administration.
After 12 months of oral administration by patients with osteoporosis, no more than double accumulation of the drug in plasma was observed. With iv administration of ibandronic acid with an interval of 4 weeks for 48 weeks in patients with metastatic bone lesions, systemic cumulation was not observed.
The total clearance of ibandronic acid is low with average values of 84-160 ml / min. Renal clearance (60 ml / min in healthy menopausal women) accounts for 50-60% of the total clearance and depends on the creatinine clearance. The difference between include and renal clearance reflects the uptake of the substance in the bone.
Pharmacokinetics in special patient groups
The pharmacokinetics and bioavailability of ibandronic acid are not dependent on gender. There were also no clinically significant interracial differences in the distribution of ibandronic acid in persons of the Caucasian and Mongoloid race. Not enough data regarding the Negroid race.
Patients with impaired renal function
Exposure of ibandronic acid in patients with various impaired renal function depends on creatinine clearance (CC).
In patients with severe impaired renal function (CC> 50 and> 30 and ® in persons under 18 years of age are absent.
Metastatic bone damage in order to reduce the risk of hypercalcemia, pathological fractures, reduce pain, reduce the need for radiation therapy for follow and the threat of fractures.
Hypercalcemia in malignant neoplasms.
Hypersensitivity to ibandronic acid or other components of the drug.
Children's age (lack of clinical experience).
Pregnancy and lactation.
Hypersensitivity to other bisphosphonates.
Creatinine clearance less than 50 ml / min.
Pregnancy and lactation
Bondronat ® should not be used during pregnancy. During preclinical studies, a violation of effective was revealed, as well as a decrease in the number of embryos (implantation sites), a violation of the normal process of childbirth (dystocia). No fetotoxic or teratogenic effects were found. An increase in the frequency of visceral abnormalities was detected (narrowing of the ureteropelvic segment).
Pregnant women have no experience using Bondronat ®.
It is not known whether Bondronat ® is excreted in breast milk in women.
In studies in rats, the presence of a small amount of ibandronic acid in milk was found after intravenous administration of the drug.
Do not use Bondronate ® during lactation.
Dosage and administration
Bondronate ® in capsule form of a concentrate for the preparation of a solution for infusion is usually used in a hospital.
Metastatic bone damage
6 mg iv drip for at least 15 minutes, once every 3-4 weeks.
The concentrate for the preparation of the solution for infusion should be diluted in 100 ml of 0.9% sodium chloride solution or 5% https://zentherapycenter.com/let-b/betoblock.php solution.
Hypercalcemia in malignant neoplasms
Bondronate ® is used only in the form of 1-2 hour intravenous infusions. The concentrate for the preparation of a solution for infusion is diluted in 500 ml of a 0.9% sodium chloride solution or in 500 ml of a 5% dextrose solution.
Therapy with Bondronat ® begins after adequate hydration with 0.9% sodium chloride solution. The dose of the drug depends on the severity of hypercalcemia, as well as on the type of malignant neoplasm. As a rule, patients with osteolytic metastases require lower doses of the drug than patients with the humoral type of hypercalcemia. In most cases, patients with severe hypercalcemia (serum albumin-corrected calcium> 3 mmol / L or> 12 mg / dl) are given 4 mg once. Patients with moderate hypercalcemia (serum albumin-corrected calcium metastatic bone damage
In case of mild renal impairment (creatinine clearance> 50 and> 30 and 1 Infusion Volume 2 > 50 and> 30 and 1 with the introduction of 1 time in 3-4 weeks
2 0.9% sodium chloride solution or 5% dextrose solution
In patients with KK ® when taken orally or intravenously.
There is no specific information about the treatment in case of an overdose of the drug. However, with an overdose of the drug taken orally, the development of undesirable phenomena, such as upset stomach, heartburn, esophagitis, gastritis, or an ulcer, is possible.
To bind the drug taken orally, milk or antacids should be used. Due to the risk of irritation of the esophagus, vomiting cannot be caused and it is necessary to remain in an upright position.
Conducting standard hemodialysis procedures leads to a significant decrease in the concentration of ibandronic acid in blood plasma.
The following frequency categories are used to estimate the frequency of undesirable effects: very often (> 10%); Often (> 1%,> 0.1%,> 0.01%, ® at a dose of 2 and 4 mg for the treatment of hypercalcemia in malignant diseases, the following adverse reactions were observed:
from the body as a whole: very often - fever. fact that of metastatic bone damage
With the intravenous administration of the drug Bondronat ® in a dose of 6 mg with a 4-week interval for the treatment of metastatic bone damage, the following adverse reactions were observed:
from the body as a whole: often - asthenia, flu-like syndrome;
from the digestive system: often - diarrhea;
from the musculoskeletal system: often - https://zentherapycenter.com/let-b/bioc.php
from the nervous system: often - headache.
Disorders from the musculoskeletal system and connective tissue: very rarely, jaw osteonecrosis was observed with the related pill of ibandronic acid.
Visual impairment: In the treatment of bisphosphonates, including ibandronic acid, inflammatory eye diseases such as episiscleritis, scleritis and uveitis have been reported. In some cases, despite the treatment, recovery did not occur until the bisphosphonates were canceled.
Interaction with other drugs
Clinically significant drug interactions are unlikely. Ibandronic acid is excreted only through the kidneys and does not undergo biotransformation. The ibandronic acid excretion route does not include any transport systems involved in the excretion of other drugs. Ibandronic acid does not inhibit or induce (shown in rat studies) the activity of the main isoenzymes of the cytochrome P450 system. In therapeutic concentrations, ibandronic acid weakly binds to blood plasma proteins; therefore, the possibility of drug interaction due to the displacement of drugs from protein binding sites is small.
There were no signs of drug-drug interaction when given concomitantly with melphalan / prednisone in patients with multiple myeloma.
In clinical studies, the administration of the drug Bondronat ® was accompanied by the simultaneous administration of various antitumor drugs, diuretics, antibiotics and analgesics without signs of clinically significant interaction.
When iv is administered in healthy volunteers and postmenopausal patients, ranitidine increased the bioavailability of ibandronic acid by 20% (however, this value is within the normal bioavailability of ibandronic acid), which is probably due to a decrease in the acidity of gastric juice. Correction of the dose of the drug with simultaneous use with N blockers2-histamine receptors or other drugs that increase the pH of the stomach are not required.
The interaction between the drug Bondronat ® and tamoxifen, hormone replacement therapy (estrogen therapy) in patients in postmenopausal women, is absent.
Bondronate ® should not be used in children due to lack of clinical experience.
Before starting therapy with Bondronat ®, hypocalcemia and other disorders of bone metabolism and electrolyte balance should be adjusted. Patients should consume adequate amounts of calcium and vitamin D.
If the patient does not receive enough calcium and vitamin D with food, then they should be taken in the form of dietary supplements.
Perhaps the development of hypocalcemia. In this case, patients should undergo appropriate correction of serum calcium levels.
The drug for parenteral administration is administered only intravenously. Avoid accidental intra-arterial administration of the drug or getting make use surrounding tissues, which can lead to damage.
Clinical placebo-controlled randomized trials involving patients with metastatic bone lesions in breast cancer showed no impaired renal function with long-term use of the drug Bondronat ®. Despite this, according to the clinical evaluation of each patient, renal function, serum calcium, phosphorus and magnesium should be monitored during treatment.
Overhydration should be avoided in patients at risk of developing heart failure.
When prescribing bisphosphonates, cases of development of jaw osteonecrosis have rarely been noted. Most cases have been reported in cancer patients during dental procedures, several cases in patients with postmenopausal osteoporosis or other diseases. Risk factors for developing jaw osteonecrosis include an established diagnosis of cancer, concomitant therapy (chemotherapy, radiation therapy, corticosteroids) and other disorders (anemia, coagulopathy, infection, and dental diseases). Most cases were noted with open link administration of bisphosphonates, but isolated cases were observed in patients receiving oral preparations.
Surgical dental intervention during treatment with bisphosphonates can enhance the manifestations of jaw osteonecrosis. It is not known whether abolition of bisphosphonates in patients if dental procedures are necessary reduces the risk of osteonecrosis. The decision to conduct treatment must be taken for each patient individually after assessing the risk / benefit ratio.
Influence on the ability to drive vehicles and work with machines and mechanisms
Studies to study the effect of the drug Bondronat ® on the ability to drive vehicles or work with machines and mechanisms have not been conducted.
Release form and packaging
Concentrate for solution for infusion, 2 mg / 2 ml and 6 mg / 6 ml
2 ml or 6 ml of the drug in a bottle of clear glass of hydrolytic type 1 (EF), corked with a rubber stopper, a laminated film of ethylene tetrafluoroethylene, crimped with an aluminum cap with a tear-off plastic cap.
Each bottle, together with instructions for use, is placed in a cardboard box.
Do not use after the expiration date indicated on the package.
At a temperature not exceeding 30 ° C.
The prepared solution for infusion is stable for 24 hours at a temperature of 2-8 ° C.
Keep out of the reach of children.
Pharmacy Vacation Terms
Owner of Registration Certificate
F. Hoffmann-La Roche Ltd., Grenzacherstrasse 124, 4070 Basel, Switzerland
F. Hoffmann-La Roche Ltd., Grenzacherstrasse 124, 4070 Basel, Switzerland