Ibanox Drug Interactions

Medicinal product-Food Interactions: Oral bioavailability of ibandronic acid is generally reduced in the presence of food. In particular, products containing calcium, including milk, and other multivalent cations (such as aluminium, magnesium, iron), are likely to interfere with absorption of ibandronic acid, which is consistent with findings in animal studies. Therefore, patients should fast overnight (at least 6 hours) before taking ibandronic and continue fasting for 1 hour following intake of ibandronic acid (see Dosage & Administration).
Interactions with other medicinal products: Metabolic interactions are not considered likely, since ibandronic acid does not inhibit the major human hepatic P450 isoenzymes and has been shown not to induce the hepatic cytochrome P450 system in rats (see Pharmacology: Pharmacokinetics under Actions). Ibandronic acid is eliminated by renal excretion only and does not undergo any biotransformation.
Calcium supplements, antacids and some oral medicinal products containing multivalent cations: Calcium supplements, antacids and some oral medicinal products containing multivalent cations (such as aluminium, magnesium, iron) are likely to interfere with the absorption of ibandronic acid.
Therefore, patients should not take other oral medicinal products for at least 6 hours before taking ibandronic acid and for 1 hour following intake of ibandronic acid.
Acetylsalicylic acid and NSAIDs: Since Acetylsalicylic acid, Nonsteroidal Anti-Inflammatory medicinal products (NSAIDs) and bisphosphonates are associated with gastrointestinal irritation, caution should be taken during concomitant administration (see Precautions).
H₂ blockers or proton pump inhibitors: Of over 1,500 patients enrolled in study BM 16549 comparing monthly with daily dosing regimens of ibandronic acid, 14% and 18% of patients used histamine (H₂) blockers or proton pump inhibitors after one and two years, respectively. Among these patients, the incidence of upper gastrointestinal events in the patients treated with ibandronic acid 150 mg once monthly was similar to that in patients treated with ibandronic acid 2.5 mg daily.
In healthy male volunteers and postmenopausal women, intravenous administration of ranitidine caused an increase in ibandronic acid bioavailability of about 20%, probably as a result of reduced gastric acidity. However, since this increase is within the normal variability of the bioavailability of ibandronic acid, no dose adjustment is considered necessary when ibandronic acid is administered with H₂-antagonists or other active substances which increase gastric pH.