# Ibandronic acid

Source: https://onco.cc/drugs/ibandronic-acid/  
OnCo record `ibandronic-acid` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Ibandronic acid (Bondronat) is a bisphosphonate available in Europe as a monthly infusion or daily tablet to prevent fractures and other bone complications in women with breast cancer that has spread to bone, and to treat cancer-related high calcium.

## Summary

Ibandronic acid was authorised by the European Commission in June 1996 for tumour-induced hypercalcaemia and later for prevention of skeletal events (pathological fractures, bone complications requiring radiotherapy or surgery) in patients with breast cancer and bone metastases, on placebo-controlled trials of intravenous 6 mg every three to four weeks and oral 50 mg daily that reduced skeletal morbidity. It is the only bisphosphonate with an oral formulation licensed for bone metastases; in the US ibandronate (Boniva) is approved for osteoporosis only. The ZICE trial found oral ibandronate slightly less effective than zoledronic acid for skeletal events, so guidelines list it as an alternative. Renal toxicity is lower than with zoledronic acid; osteonecrosis of the jaw and oesophageal irritation with tablets are the recognised risks. Originated by Roche.

## Fields

- Kind: Treatment
- Status: approved
- Last checked: 2026-09-10
- Also known as: Ibandronate; Boniva (osteoporosis formulation); Bonviva
- Tags: ema-list; supportive
- Brand: Bondronat
- Modality: Nitrogen-containing bisphosphonate (intravenous and oral)
- Mechanism: Binds bone mineral and inhibits farnesyl pyrophosphate synthase in osteoclasts, suppressing bone resorption and lowering tumour-induced calcium release.
- Approvals: EU 1996: Tumour-induced hypercalcaemia; prevention of skeletal events in breast cancer with bone metastases (Bondronat)

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Ibandronic_acid
- EPAR (EMA): https://www.ema.europa.eu/en/medicines/human/EPAR/bondronat

## Connected records

- drugs: [Denosumab](https://onco.cc/drugs/denosumab/), [Zoledronic acid](https://onco.cc/drugs/zoledronic-acid/)
- cancers: [HR-positive / HER2-negative breast cancer](https://onco.cc/cancers/breast-hr-positive/)
- technologies: [Bone-modifying agents (bisphosphonates, denosumab)](https://onco.cc/technologies/bone-modifying-agents/)
- companies: [Roche / Genentech](https://onco.cc/companies/roche-genentech/)
- trials: [Comparison of Ibandronate - Zoledronate Regarding Nephrotoxicity in Multiple Myeloma](https://onco.cc/trials/nct02739594/), [Ibandronate or Zoledronate in Treating Patients With Newly Diagnosed Bone Metastases From Breast Cancer](https://onco.cc/trials/nct00326820/), [Single-Dose Local Radiation Therapy Compared With Ibandronate in Treating Patients With Localized Metastatic Bone Pain](https://onco.cc/trials/nct00082927/)

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