Bonviva (ibandronate) is a biphosphonate for the treatment of osteoporosis. Bonviva 150 mg differs from other biphosphonates in respect of its once monthly administration, which can be advantageous since it makes it possible for the physician to choose from different regimes of treatment.
Bonviva 2.5 mg a day has a documented vertebral fracture prophylaxis. Compared to Bonviva 2.5 mg a day, Bonviva 150 mg a month has a significantly larger response in bone mineral density (BMD). As regards the monthly regime, there is no documentation on fractures, but a biological relation to the daily regime has been established. This is analogous to e.g. alendronate 70 mg weekly, for which regime no documentation on fractures exist either. In contrast, alendronate 10 mg a day is documented as regards fractures.
Adverse effects are comparable to biphosphonates in general, but problems related to compliance are very relevant, since a whole month of treatment is lost, if a single tablet are forgot or the patient is unaware of food interactions.
The price is comparable to the most expensive biphosphonates, but considerably more expensive than e.g. alendronate, which is better documented and is currently in generic production. Hence, it is irrational to make Bonviva the drug of first choice. Alendronate should be chosen whenever prophylaxis of non-vertebral fractures is the object of primary interest (alendronate exhibits prophylaxis of vertebral fractures as well), whereas – if the primary interest is prevention of vertebral fractures – the physician can choose between alendronate and etidronate.
General reimbursement has not been granted for Bonviva, but individual reimbursement can be applied for.
Bonviva was marketed on November 17th 2005.
Last modified: November 30th 2005