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Drug Interactions between Atelvia and Neo-Fradin

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

neomycin risedronate

Applies to: Neo-Fradin (neomycin) and Atelvia (risedronate)

MONITOR: Coadministration of bisphosphonates and aminoglycosides may potentiate the risks of hypocalcemia and nephrotoxicity, particularly when the bisphosphonate is administered intravenously. Bisphosphonates alone often cause mild, asymptomatic hypocalcemia via inhibitive effects on bone resorption and possibly chelation of blood calcium, while aminoglycosides can induce renal tubular damage resulting in renal loss of calcium and magnesium. Hypomagnesemia, in turn, may also lead to peripheral parathyroid hormone resistance and impaired parathyroid hormone secretion, thus compromising the normal homeostatic response to hypocalcemia. The interaction has been reported in a 62-year-old patient with multiple myeloma who developed persistent, severe hypocalcemia and hypomagnesemia after treatment with oral clodronate and netilmicin. The electrolyte abnormalities were accompanied by increased serum creatinine concentration and grand mal seizures. Administration of bisphosphonates, especially by rapid IV injection, has also been associated with nephrotoxicity manifested as deterioration of renal function and renal failure.

MANAGEMENT: Caution is advised if bisphosphonates are used in patients who have recently received or are receiving treatment with aminoglycosides. Renal function as well as serum calcium and magnesium levels should be monitored during and after treatment, since renal loss of calcium and magnesium can continue for many weeks after cessation of aminoglycosides, as can the effect of bisphosphonates. Patients and clinicians should be alert to signs and symptoms of clinical hypocalcemia such as muscle spasms, carpopedal spasm, laryngeal spasm, tetany, convulsions, mental changes (irritability, depression, psychosis), increased intracranial pressure, papilledema, QT interval prolongation, and cardiac arrhythmias. For IV bisphosphonates, product labelings for pamidronate and zoledronic acid recommend that single doses not exceed 90 mg and 4 mg, respectively, and duration of infusion not less than 2 hours and 15 minutes, respectively.

References

  1. Pedersen-Bjergaard U, Myhre J "Severe hypocalcaemia [corrected] after treatment with diphosphonate and aminoglycoside." Br Med J 302 (1991): 295
  2. Kanis JA, Preston CJ, Yates AJ, Percival RC, Mundy KI, Russell RG "Effects of intravenous diphosphonates on renal function." Lancet 1 (1983): 1328
  3. Osullivan TL, Akbari A, Cadnapaphornchai P "Acute renal failure associated with the administration of parenteral etidronate." Ren Fail 16 (1994): 767-73
  4. Zazgornik J, Grafinger P, Biesenbach G, Hubmann R, Fridrik M "Acute renal failure and alendronate." Nephrol Dial Transplant 12 (1997): 2797-8
  5. "Product Information. Zometa (zoledronic acid)." Novartis Pharmaceuticals PROD (2001):
  6. Janssen Van Doorn K, Neyns B, Van Der Niepen P, Verbeelen D "Pamidronate-related nephrotoxicity (tubulointerstitial nephritis) in a patient with osteolytic bone metastases." Nephron 89 (2001): 467-8
  7. Lockridge L, Papac RJ, Perazella MA "Pamidronate-associated nephrotoxicity in a patient with Langerhans's histiocytosis." Am J Kidney Dis 40 (2002): E2
  8. Markowitz GS, Fine PL, Stack JI, et al. "Toxic acute tubular necrosis following treatment with zoledronate (Zometa)." Kidney Int 64 (2003): 281-289
  9. Banerjee D, Asif A, Striker L, Preston RA, Bourgoignie JJ, Roth D "Short-term, high-dose pamidronate-induced acute tubular necrosis: The postulated mechanisms of bisphosphonate nephrotoxicity." Am J Kidney Dis 41 (2003): E18
  10. Chang JT, Green L, Beitz J "Renal failure with the use of zoledronic acid." N Engl J Med 349 (2003): 1676-9; discussion 1676-9
  11. "Product Information. Ostac (clodronate)." Hoffmann-La Roche Limited (2004):
View all 11 references

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Drug and food interactions

Moderate

risedronate food

Applies to: Atelvia (risedronate)

ADJUST DOSING INTERVAL: Food significantly decreases the bioavailability of risedronate, possibly to negligible levels.

MANAGEMENT: Risedronate should be administered with 180 to 240 mL (6 to 8 ounces) of plain water, at least 30 minutes before the first food, beverage, or medication of the day. Patients should remain upright for at least 30 minutes following administration of risedronate.

References

  1. "Product Information. Actonel (risedronate)." Procter and Gamble Pharmaceuticals PROD (2001):

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

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