BONIVA (ibandronate)

BONIVA (ibandronate)

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; AND
• 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

Dosing:

• For Osteoporosis Treatment
• The recommended dose is 3 mg every three months administered over a period of 15 to 30 seconds