Ibandronic acid explained

Verifiedfields:changed
Watchedfields:changed
Verifiedrevid:461936767
Tradename:Boniva, Bonviva, Bondronat, others
Licence Eu:yes
Dailymedid:Ibandronate_sodium
Licence Us:Ibandronate_sodium
Pregnancy Au:B3
Routes Of Administration:By mouth, intravenous
Atc Prefix:M05
Atc Suffix:BA06
Legal Us:Rx-only
Legal Eu:Rx-only
Legal Eu Comment:[1] [2] [3]
Legal Status:Rx-only
Bioavailability:0.6%
Protein Bound:90.9 to 99.5%
(concentration-dependent)
Metabolism:Nil
Elimination Half-Life:10 to 60 hours
Excretion:Kidney
Index2 Label:as salt
Iuphar Ligand:3059
Cas Number:114084-78-5
Pubchem:60852
Drugbank:DB00710
Chemspiderid:54839
Unii:UMD7G2653W
Kegg:D08056
Kegg2:D04486
Chebi:93770
Chembl:997
Pdb Ligand:BFQ
Iupac Name:Hydroxy-[1-hydroxy-3-[methyl(pentyl)amino]-1-phosphonopropyl]phosphinate
C:9
H:23
N:1
O:7
P:2
Smiles:O=P(O)(O)C(O)(CCN(CCCCC)C)P(=O)(O)O
Stdinchi:1S/C9H23NO7P2/c1-3-4-5-7-10(2)8-6-9(11,18(12,13)14)19(15,16)17/h11H,3-8H2,1-2H3,(H2,12,13,14)(H2,15,16,17)
Stdinchikey:MPBVHIBUJCELCL-UHFFFAOYSA-N

Ibandronic acid is a bisphosphonate medication used in the prevention and treatment of osteoporosis and metastasis-associated skeletal fractures in people with cancer.[4] It may also be used to treat hypercalcemia (elevated blood calcium levels). It is typically formulated as its sodium salt ibandronate sodium.

It was patented in 1986 by Boehringer Mannheim and approved for medical use in 1996.[5]

Medical uses

Ibandronate is indicated for the treatment and prevention of osteoporosis in post-menopausal women.[6] In May 2003, the US Food and Drug Administration (FDA) approved ibandronate as a daily treatment for post-menopausal osteoporosis. The basis for this approval was a three-year, randomized, double-blind, placebo-controlled trial women with post-menopausal osteoporosis. Each participant also received daily oral doses of calcium and 400IUs [international units] of vitamin D. At the study's conclusion, both doses significantly reduced the occurrence risk of new vertebral fractures by 50–52 percent when compared to the effects of the placebo drug.

Ibandronate is efficacious for the prevention of metastasis-related bone fractures in multiple myeloma, breast cancer, and certain other cancers.[7]

Adverse effects

In 2008, the US Food and Drug Administration (FDA) issued a communication warning of the possibility of severe and sometimes incapacitating bone, joint or muscle pain.[8] A study conducted by the American Society of Bone and Mineral Research concluded that long-term use of bisphosphonates, including Boniva, may increase the risk of a rare but serious fracture of the femur.[9] The drug also has been associated with osteonecrosis of the jaw, a relatively rare but serious condition.[10]

Pharmacology

Mechanism of action

Nitrogen containing bisphosphonates, which include ibandronate, pamidronate and alendronate exert their effects on osteoclasts mainly by inhibiting the synthesis of isoprenoid lipids such as isopentenyl diphosphate (IPP), farnesyl diphosphate (FPP), and geranylgeranyl diphosphate (GGPP) via the mevalonate pathway. These isoprenoids are used in posttranslational modifcation(prenylation) of small GTPases such as Ras, Rho, and Rac. These prenylated GTPases are necessary for various cellular processes including osteoclast morphology, endosome trafficking, and apoptosis.[11]

Relative potency[12] !Bisphosphonate!Relative potency
Etidronate1
Tiludronate10
Pamidronate100
Alendronate100-500
Ibandronate500-1000
Risedronate1000
Zoledronate5000

Society and culture

Brand names

Ibandronic acid is sold under the brand names Boniva, Bondronat, Bonviva, Bandrone, Ibandrix, Adronil, Bondrova, Bonprove, and Fosfonat.

Notes and References

  1. Web site: Bondronat EPAR . European Medicines Agency (EMA) . 25 June 1996 . 28 August 2024.
  2. Web site: Bonviva EPAR . European Medicines Agency (EMA) . 23 February 2004 . 28 August 2024.
  3. Web site: Iasibon EPAR . European Medicines Agency (EMA) . 21 January 2011 . 30 August 2024.
  4. Bauss F, Schimmer RC . Ibandronate: the first once-monthly oral bisphosphonate for treatment of postmenopausal osteoporosis . Therapeutics and Clinical Risk Management . 2 . 1 . 3–18 . March 2006 . 18360577 . 1661644 .
  5. Book: Fischer J, Ganellin CR . Analogue-based Drug Discovery . 2006 . John Wiley & Sons . 9783527607495 . 523 .
  6. Web site: Boniva. The American Society of Health-System Pharmacists . 3 April 2011.
  7. Sittig HB . Pathogenesis and bisphosphonate treatment of skeletal events and bone pain in metastatic cancer: focus on ibandronate . Onkologie . 35 . 6 . 380–7 . 2012 . 22722461 . 10.1159/000338947 . 8413102 .
  8. Web site: Information for Healthcare Professionals: Bisphosphonates (marketed as Actonel, Actonel+Ca, Aredia, Boniva, Didronel, Fosamax, Fosamax+D, Reclast, Skelid, and Zometa). U.S. Food and Drug Administration. 27 October 2010.
  9. Shane E, Burr D, Ebeling PR, Abrahamsen B, Adler RA, Brown TD, Cheung AM, Cosman F, Curtis JR, Dell R, Dempster D, Einhorn TA, Genant HK, Geusens P, Klaushofer K, Koval K, Lane JM, McKiernan F, McKinney R, Ng A, Nieves J, O'Keefe R, Papapoulos S, Sen HT, van der Meulen MC, Weinstein RS, Whyte M . 6 . Atypical subtrochanteric and diaphyseal femoral fractures: report of a task force of the American Society for Bone and Mineral Research . Journal of Bone and Mineral Research . 25 . 11 . 2267–2294 . November 2010 . 20842676 . 10.1002/jbmr.253 . 15194275 . American Society for Bone and Mineral Research . free .
  10. Web site: Osteonecrosis of the jaw (ONJ) and drug treatments for osteoporosis . United Kingdom . The National Osteoporosis Society. 14 August 2018. 17 June 2017. https://web.archive.org/web/20170617084719/https://nos.org.uk/media/1593/k-drug-treatments-for-osteoporosis-osteonecrosis-of-the-jaw-onj-_.pdf. dead.
  11. Rogers MJ, Gordon S, Benford HL, Coxon FP, Luckman SP, Monkkonen J, Frith JC . Cellular and molecular mechanisms of action of bisphosphonates . Cancer . 88 . 12 Suppl . 2961–2978 . June 2000 . 10898340 . 10.1002/1097-0142(20000615)88:12+<2961::AID-CNCR12>3.0.CO;2-L .
  12. Book: Essentials of Medical Pharmacology . Tripathi KD . 9789350259375. Seventh. New Delhi . Jaypee Brothers Medical Publisher . 868299888. 30 September 2013.