Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Bonviva for postmenopausal osteoporosis

Ibandronic Acid (Bonviva) is licensed and available on the NHS for "Treatment of osteoporosis in postmenopausal women in order to reduce the risk of vertebral fractures".

This is a new bisphosphonate with the novelty of a once monthly administration. The marketing of this product is focussed on this aspect of the product and also on the improved effect on Bone Mineral Density.

It should be noted that the SPC specifies that "Efficacy on femoral neck fractures has not been established" and therefore this drug should not be considered as an alternative for established treatments like Alendronate without good reason.

Poor compliance with any bisphosphonate should be investigated fully and information should be given to the patient about strategies for taking bisphosphonates before a change of treatment is made.

Action: In a very small number of patients who cannot manage to comply with bisphosphonate therapy (for reasons other than side effects) it may be appropriate to change to Ibandronic Acid. These patients should be made aware of the lack of efficacy data on femoral neck fractures.

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