Ibandren Drug Interactions

Medicinal Product-Food Interaction: Oral bioavailability of Ibandronic acid is generally reduced in the presence of food. In particular, products containing calcium, including milk and other multivalent cations (such as aluminum, magnesium, iron), are likely to interfere with absorption of Ibandronic acid, which is consistent in animal studies. Patients should fast overnight (at least 6 hours) before taking Ibandronic acid and continue fasting for 1 hour following the intake of Ibandronic acid.
Interactions with other Medicinal Products: Metabolic interactions are not considered likely, since Ibandronic acid does not inhibit the major hepatic P450 isoenzymes and have been shown not to induce the hepatic cytochrome P450 system in rats. Ibandronic acid is eliminated by renal excretion only and does not undergo any biotransformation.
Acetylsalicylic acid and NSAIDs: Acetylsalicylic acid, Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) and bisphosphonates are associated with gastrointestinal irritation. Caution should be taken during concomitant administration.
H2 blockers or Proton Pump Inhibitors: Of over 1500 patients enrolled in study BM 16549 comparing monthly with daily dosing regimens of Ibandronic acid, 14% and 18% of patients used histamine (H2) blockers or Proton Pump Inhibitors after one and two years, respectively. Among these patients, the incidence of upper gastrointestinal events in the patients treated with Ibandronic acid 150 mg once monthly is similar to that in patients treated with Ibandronic acid 2.5 mg daily. In healthy male volunteers and postmenopausal women, intravenous administration of ranitidine cause and increase in Ibandronic acid bioavailability of about 20%, probably as a result of reduced gastric acidity. However, since this increase is within the normal variability of the bioavailability of Ibandronic acid, no dose adjustment is considered necessary when Ibandronic acid is administered with H2-antagonists or other active substances which increase gastric pH.