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Boniva is prescribed to prevent and treat osteoporosis in postmenopausal women. It belongs to the same category as Fosamax.

Bone is constantly being "remodeled," broken down by osteoclasts and rebuilt by osteoblasts. Under normal conditions, these two types of bone cells should work together.

With aging, the osteoblasts often slow down, and more bone is destroyed ("resorbed") than is constructed. Boniva slows the osteoclasts so that bone-building osteoblasts can keep up or get ahead, preventing fractures in the spine.

Side Effects and Interactions

Boniva may occasionally cause achiing joints, flu-like symptoms, high blood pressure, stomach ache, nausea, constipation or diarrhea, headache, or high cholesterol.

Difficulty swallowing, esophageal irritation or even ulcers are unusual but serious side effects.

Death of the jaw bone tissue is a rare but very dangerous reaction, usually associated with dental extractions or other invasive procedures.

Anyone taking Boniva who notices difficulty or pain when swallowing, pain behind the breastbone, or new or more intense heartburn should stop the drug and contact the physician promptly.

Other side effects such as muscle pain, skin reactions and eye inflammation have also been reported.

Boniva will be most effective if the user gets adequate calcium and vitamin D, but supplements should not be taken within 2 hours of the medication.

Aspirin and arthritis pain relievers, both prescription and over-the-counter, can irritate the digestive tract. This may increase the risk of severe esophageal irritation from Boniva. Antacids should be taken at least 2 hours after Boniva. They could interfere with absorption if given at the same time.

Check with your doctor and pharmacist to make sure this medicine is safe in combination with any other drugs you take.

Special Precautions

Boniva can be very irritating to the esophagus. People with any swallowing problems or those who cannot sit or stand for at least one hour after taking the pill should not take Boniva.

People with ulcers or esophageal disease should also avoid Boniva.

Boniva is not recommended for patients with severe kidney disease.

Taking the Medicine

Boniva is not well absorbed, and must be taken exactly according to instructions.

The pill is to be taken first thing in the morning, right after rising, with a full glass of plain tap water.

Mineral water, coffee, and orange juice may all interfere with drug absorption.

The patient must stay upright, sitting up or standing (not lying down), for at least 60 minutes after taking Boniva. Only after that hour has elapsed should she have breakfast, drink coffee or juice, or take other medications.

Boniva may be taken every day or once a month. The same instructions apply to the monthly dose.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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