Pharmacology · single question
Ibandronate — what is the risk associated with this bisphosphonate?
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Correct answer: B. Osteonecrosis of the jaw (MRONJ)
- A. IV bisphosphonates (especially zoledronic acid) can cause renal toxicity — oral bisphosphonates have much lower renal risk.
- B. Ibandronate is an ORAL BISPHOSPHONATE used for osteoporosis. Bisphosphonates (both oral and IV) are associated with MEDICATION-RELATED OSTEONECROSIS OF THE JAW (MRONJ) — exposed, necrotic jaw bone that does not heal. The risk is much higher with IV bisphosphonates (zoledronic acid for cancer) but exists for oral bisphosphonates (alendronate, ibandronate) especially with prolonged use >3 years. Dental extractions and implants are the most common triggers.
- C. Bisphosphonates REDUCE fracture risk by preventing bone resorption — they are prescribed specifically to PREVENT osteoporotic fractures.
- D. Bisphosphonates are not significantly hepatotoxic — MRONJ is the primary dental concern.