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Will Boniva Interact with Her Pain Reliever?

Does Boniva interact with other medications? This osteoporosis drug together with an NSAID might increase the possibility of digestive tract problems.

You may think of bones as hard and unchanging, but that is a misconception. Living bones are constantly undergoing remodeling. Some cells break down bone tissue while other cells build it up. If the breakdown crew gets ahead of the construction crew, a person may develop porous, weak bones. Doctors call this condition osteoporosis. They can choose from among several prescription drugs to treat it. The bisphosponates are among the most popular: alendronate (Fosamax), ibandronate (Boniva), risedronate (Actonel) and zoledronic acid (Reclast). All work by slowing bone breakdown. But do they, especially Boniva, interact with other medicines?

Sally Field Promoted Boniva:

Q. I was recently prescribed ibandronate (Boniva) after being diagnosed with osteoporosis. I must admit the TV ads with Sally Field may have influenced me to choose that particular bisphosphonate. I’ve taken three doses so far, with some trepidation.

I’m 70 years old and still working full time as a nurse but not getting as much exercise as I need. My friends and family think I should not take this drug due to possible side effects. My gynecologist, my endocrinologist and my periodontist urge me to take it. They say I have a good chance of living another 20 years and the drug would make me less susceptible to fractures.

Now I have a prescription for Mobic from an orthopedic surgeon I saw about a Baker’s cyst that’s causing me pain. Do these two drugs interact?

Will Boniva Interact with Mobic?

A. Meloxicam (Mobic) is a nonsteroidal anti-inflammatory drug that is prescribed for joint pain. NSAIDs can be irritating to the digestive tract. However, at low doses, meloxicam is somewhat less likely to cause serious gastrointestinal consequences than other NSAIDs such as diclofenac (American Journal of Medicine, July 15, 2004).

Doctors consider ibandronate an effective treatment for postmenopausal osteoporosis (Bone, Jan. 2014). Because ibandronate can also cause indigestion, gastritis and abdominal pain, the combination may be hard on the stomach. People who must take both an NSAID and a bisphosphonate drug like ibandronate or alendronate are more likely to suffer peptic ulcers (Journal of Gastroenterology, Feb. 13, 2009). Acid-suppressing drugs such as ranitidine can mitigate this possible reaction.

Ask your doctor if you should stop the ibandronate while you take meloxicam. Scientists have not studied this combination extensively, so your physician’s clinical judgment will be helpful in determining will Boniva interact with Mobic to put you in danger.

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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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  • Singh G et al, "Risk of serious upper gastrointestinal and cardiovascular thromboembolic complications with meloxicam." American Journal of Medicine, July 15, 2004. DOI: 10.1016/j.amjmed.2004.03.012
  • Eriksen EF et al, "Update on long-term treatment with bisphosphonates for postmenopausal osteoporosis: a systematic review." Bone, Jan. 2014. DOI: 10.1016/j.bone.2013.09.023
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