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Drugs - Bisphosphonates

December 2012

Therapeutic area - Osteoporosis

PDL Status



Preferred Nonpreferred
alendronate Actonel/ibandronate PA
Atelvia (risedronate) PA
Binosto PA
Boniva tablets and injectable PA
Fosamax PA
Fosamax Plus D

Approval criteria

Actonel, branded Fosamax or Boniva/ibandronate tablets

  • Patient has had intolerable side effects from alendronate (Fosamax) after having been instructed to stand or sit upright for at least 30 minutes
  • If patient is to receive Boniva or ibandronate, patient must be informed to stand or sit upright for at least 60 minutes after taking it


  • Patient must have tried and failed by intolerance BOTH alendronate generic and Actonel AND
  • Prescriber must provide rationale why new formulation of risedronate in Atelvia will provide better results


  • Patient must have tried and failed alendronate, ibandronate and Actonel OR
  • Intolerance to alendrondate, ibandronate or Actonel, defined as moderate or severe upper GI tract irritation due to the tablet formulation OR
  • Diagnoses of dysphagia

Boniva Infusion

  • Boniva infusion is approved for use only after the prescriber or pharmacy provides a reasonable explanation of why the patient cannot take a bisphosphonate by mouth (e.g., Roux-en-Y Bariatric Surgery)


MHCP Provider Call Center 651-431-2700 or 800-366-5411

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