Ibandronate (Boniva IV)


Indications for Prior Authorization:

  • Osteoporosis

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; AND
  • 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


Last review date: December 2, 2013

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