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Ibandronate Side Effects

In Summary

Commonly reported side effects of ibandronate include: bronchitis and arthralgia. Other side effects include: arthralgia and myalgia. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to ibandronate: oral tablet

Other dosage forms:

In addition to its needed effects, some unwanted effects may be caused by ibandronate. In the event that any of these side effects do occur, they may require medical attention.

Major Side Effects

You should check with your doctor immediately if any of these side effects occur when taking ibandronate:

More common:
  • Bladder pain
  • bloody or cloudy urine
  • chest pain
  • cough producing mucus
  • difficult, burning, or painful urination
  • difficulty with breathing
  • fever or chills
  • frequent urge to urinate
  • lower back or side pain
  • nervousness
  • pounding in the ears
  • shortness of breath
  • slow or fast heartbeat
  • sneezing
  • sore throat
  • tightness in the chest
Less common:
  • Bloody or cloudy urine
  • body aches or pain
  • congestion
  • difficulty with swallowing
  • dizziness
  • dryness of the throat
  • fast heartbeat
  • frequent urge to urinate
  • hives
  • hoarseness
  • itching
  • numbness
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • runny nose
  • skin rash
  • tender, swollen glands in the neck
  • tingling
  • unusual tiredness or weakness
  • voice changes
Incidence not known:
  • Abdominal or stomach cramps
  • blurred vision or other change in vision
  • bone, joint, or muscle pain, severe and occasionally incapacitating
  • confusion
  • convulsions
  • eye redness
  • eye tenderness
  • heavy jaw feeling
  • irregular heartbeats
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • loosening of a tooth
  • muscle cramps in the hands, arms, feet, legs, or face
  • noisy breathing
  • numbness and tingling around the mouth, fingertips, or feet
  • pain, swelling, or numbness in the mouth or jaw
  • sensitivity to light
  • severe eye pain
  • tearing
  • tremor
  • unusual pain in the thighs, groin, or hips

If any of the following symptoms of overdose occur while taking ibandronate, get emergency help immediately:

Symptoms of overdose:
  • Acid or sour stomach
  • belching
  • bone pain
  • burning feeling in the chest or stomach
  • heartburn
  • indigestion
  • loss of appetite
  • pain or burning in the throat
  • sores or ulcers
  • stomach discomfort, upset, or pain
  • tenderness in the stomach area
  • vomiting
  • white spots on the lips or tongue or inside the mouth

Minor Side Effects

Some of the side effects that can occur with ibandronate may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More common:
  • Diarrhea
  • ear congestion
  • headache
  • loss of voice
  • pain in the extremity (arms and legs)
Less common:
  • Cough
  • difficulty having a bowel movement (stool)
  • difficulty with moving
  • discouragement
  • feeling of constant movement of self or surroundings
  • feeling sad or empty
  • general feeling of discomfort or illness
  • irritability
  • joint pain
  • lack or loss of strength
  • lightheadedness
  • loss of interest or pleasure
  • muscle aches and pain
  • muscle stiffness
  • pain, swelling, or redness in the joints
  • sensation of spinning
  • shivering
  • stuffy nose
  • sweating
  • tooth disorder
  • trouble concentrating
  • trouble sleeping

For Healthcare Professionals

Applies to ibandronate: intravenous kit, intravenous solution, oral tablet


The most serious reported adverse reactions are anaphylactic reaction/shock, atypical fractures of the femur, osteonecrosis of the jaw, and ocular inflammation.

The most frequently reported adverse reactions are arthralgia and influenza-like symptoms, typically associated with the first dose, generally of short duration, mild, or moderate intensity.[Ref]


Very common (10% or more): Dyspepsia (up to 12%)
Common (1% to 10%): Diarrhea, tooth disorder, vomiting, gastritis, constipation, gastroenteritis abdominal pain, esophagitis, nausea, sore throat
Uncommon (0.1% to 1%): Hemorrhage, duodenal ulcer, dysphagia, dry mouth[Ref]


Very common (10% or more): Upper respiratory infection (up to 34%)
Common (1% to 10%): Bronchitis, pneumonia, pharyngitis, influenza, nasopharyngitis, asthma exacerbation
Uncommon (0.1% to 1%): Chest pain[Ref]


Very common (10% or more): Hypocalcemia
Postmarketing reports: Hypocalcemia[Ref]

Decreased renal calcium excretion may be accompanied by a fall in serum phosphate levels not requiring therapeutic measures. The serum calcium level may fall to hypocalcemic values.[Ref]


Very common (10% or more): Back pain (14%)
Common (1% to 10%): Pain in the extremity, myalgia, join disorder, arthritis, arthralgia, localized osteoarthritis, muscle cramp
Postmarketing reports: Severe or incapacitating bone, join, or muscle pain (musculoskeletal pain); osteonecrosis of the jaw; atypical, low-energy, or low-trauma fractures of the femoral shaft; atypical subtrochanteric and diaphyseal femoral fractures[Ref]


Common (1% to 10%): Hypertension
Uncommon (0.1% to 1%): Phlebitis, thrombophlebitis[Ref]


Common (1% to 10%): Urinary tract infection, cystitis[Ref]


Common (1% to 10%): Increased gamma-glutamyl transpeptidase (GGT) levels[Ref]


Common (1% to 10%): Allergic reaction
Rare (less than 0.1%): Facial swelling/edema, urticaria
Postmarketing reports: Anaphylactic reaction/shock with fatalities, angioedema, bronchospasm, asthma exacerbations, rash, Stevens-Johnson syndrome, erythema multiforme, and dermatitis bullous[Ref]


Common (1% to 10%): Redness or swelling at the injection site[Ref]

Nervous system

Common (1% to 10%): Headache, dizziness, paraesthesia, dysgeusia (taste perversion)[Ref]


Common (1% to 10%): Asthenia, vertigo, influenza-like illness, peripheral edema
Uncommon (0.1% to 1%): Malaise, pain[Ref]

Combination of influenza-like illness and acute phase reaction has occurred. Influenza-like illness includes events reported as acute phase reaction or symptoms, including myalgia, arthralgia, fever, chills, fatigue, nausea, loss of appetite, and bone pain.[Ref]


Common (1% to 10%): Insomnia, depression[Ref]


Common (1% to 10%): Increased creatinine
Uncommon (0.1% to 1%): Azotemia (uremia)
Postmarketing reports: Acute renal failure[Ref]


Rash occurred in combination of rash pruritic, rash macular, rash papular, rash generalized, rash erythematous, dermatitis, dermatitis allergic, dermatitis medicamentosa, erythema and exanthema.[Ref]

Uncommon (0.1% to 1%): Pruritus, rash[Ref]


Uncommon (0.1% to 1%): Anemia, increased blood parathyroid hormone[Ref]


Postmarketing reports: Ocular inflammation, iritis, uveitis, episcleritis (in some cases, these events resolve only after this drug was discontinued)[Ref]


1. Cerner Multum, Inc. "Australian Product Information." O 0

2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

3. "Product Information. Boniva (ibandronate)." Roche Laboratories, Nutley, NJ.

Not all side effects for ibandronate may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

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