Boniva Pro’s and Con’s

Medication sequencing is very important when starting these drugs.
Here is a paper that might assist you.
https://pmc.ncbi.nlm.nih.gov/articles/PMC10118820/
Of course every patient is unique. What research have you already done? May I ask your age and dexa scores?
Do you take bhrt/hrt with testosterone? Have you been tested for secondary causes of bone loss or has it been determined that loss of hormones is the culprit (most cases are menopause related).

So I thought I would give a bit more information after reading some of the comments! I realized I did not give enough pertinent information. I’m just 76 years old and have lupus since I was 61. During those first eight years or so I was on 3 to 5 mg of prednisone daily. we stopped the prednisone about five years ago. And only recently have I begun taking 3 mg of budesonide to help with my lupus. In addition, I take thyroxine every day for a thyroid condition since I was 19. When I was 61 I had my first bone scan and I was diagnosed with osteopenia. Over the years I’ve had my yearly bone density assessments and really haven’t paid the attention to them that I should until just recently. So currently my total lumbar spine findings of L3 – L4 I have a T score of -1.2 I might add these numbers were given to me in 2025 around the same time. Compared to 2024’s finding there was a non-statistical change. I had an additional. Compared to 2024’s finding there was a non-statistical change. I had an additional DEXA scanned because I truly don’t want to start the meds so my doctor ordered another DEXA scan for me. To continue my mean total hip score is -1.9. Again, a non-statistical change from 2024. My mean firm neck reading is a T score of -2.8 which represented a 0.6% statistical change from 2024. I’ve been put in the 19% percentile for major fracture and a 6.3% chance for hip fracture. I currently take 1200 mg of calcium every day and 5000 IU units of vitamin D. I do minor weight-bearing exercises by keeping my own home and walking daily. The only other information that I was given is that the least significant change based on 95% confidence interval is a 0.028 GM/CM 24 AP spine L1 – L4 dual femur and the distal radius. I’m not exactly sure what that means. I just feel my Dr thinks I should be on osteoporosis medicine as I had stated earlier and now is pushing me to take Boniva once a month.
I really appreciate being able to share this with other women suffering or at least going through somewhat the same thing now. I can’t seem to find information that helps me to understand if I’m at grave risk or, if I can take more time and have another test before I see if there’s any major changes. Thank you so much.

@pgn , before deciding on any drug please, PLEASE watch this video. It is a must watch about the sequence to take drugs in. Boniva might be the wrong drug to take if you have the option to take a bone builder (anabolic).

See if you can gradually increase your weights and reps. I've been weightlifting for years and start with 2 sets of 8 reps at a given weight, then do 2 sets 9 the next time,10 etc. Once I hit 2x14, I up the weight by a little bit. Have you read the Liftmor study? Weightlifting really works.

Good luck with your OP journey!

@boneoptimist
Link did not work for me.
Who is it by?

@gravity3
https://www.medscape.com/viewarticle/scenarios-show-how-plan-sequential-osteoporosis-drug-therapy-2026a10006n8
Have you seen this one?

@gravity3

@boneoptimist

Thanks. I see that it is posted above too. How in the heck did I miss that...

Yes, I watched that video because @gravity3 posted it, (Thank you @gravity3 ) but i think the thread doesn't always display the same order, depends on the latest replies and comments.

I started the once a month Boniva 7 days ago and have not had the horrible knee cramping that I had on the initial weekly prescription. Yay! However, my joints ache, my back aches to the point that I am taking Tylenol in small doses when I can't tolerate it. I am bloated in my face, neck, and stomach, and am having difficulty with feeling fatigued and in a fog like I had not felt in ten years at 50. I slept most of today because of it. I also am excessively thirsty. I really hate taking it and wonder if it is worth it because I felt fine before I was diagnosed at just -2.5 spinal, -2 hips. My doctor was not happy that I stopped the one week Boniva treatment after two months of nightly knee cramps. So, I am actually scared to stop this because of her. But, I am wondering if the studies are accurate for smaller women like me and if it is really necessary at my current age of 60? I was not given a hormone replacement therapy option; however, I would be open to anything that works without such side effects.

osteop60yay, can I assume that you are not seeing an endocrinologist.
Most of our endocrinologists are advising that we take a bone building medication before taking the medications that slow down bone loss.
Your numbers are definitely lower on Dexa if you are small boned. But, you do likely have osteopenia and at at an opportune moment to increase your bone strength and density. More than half of all frailty fractures happen to women who have osteopenia.
I don't have a medical background but I don't think someone should take a medication that makes them sick, if there is a better medication that might not make them sick. Forteo might be a much better medication for you. It certainly builds more fracture resistant bones. Your doctor shouldn't be unhappy, but they make me laugh.
Maybe you should be mad at the doctor for prescribing a drug that makes you ache, makes you fatigued bloated, foggy and thirsty. Demand a better drug, maybe.
Osteoporosis is tricky, though. We all feel fine until we fracture, then we're miserable forever.