Ibandronate (Boniva IV)
Approved for: office administration
Indications for Prior Authorization
The following indications do not meet the criteria for use established by the Western Health Advantage Pharmacy and Therapeutics Committee.
- Padget’s disease
- Prevention of Osteoporosis
All of the following must be met:
- Treatment of osteoporosis in postmenopausal woman
- T-score is more than -2.5 SD below the young normal or the presence or history of osteoporotic fracture;
- Intolerable side effects with two of the following oral bisphosphanates: Fosamax or Actonel and Boniva; OR
- Boniva injection should be reserved for patients with intrinsic swallowing mechanism defect who cannot take any oral formulary of medication.
For Osteoporosis Treatment
The recommended dose is 3 mg every three months administered over a period of 15 to 30 seconds.
Western Health Advantage Pharmacy and Therapeutics Committee
Approved/Revised: July 2007 Reviewed: December 2013