Ibandronate (Boniva IV)

Approved for: office administration

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;


  • 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