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Skelid (tiludronate) Disease Interactions

There are 3 disease interactions with Skelid (tiludronate):

Major

Bisphosphonates (applies to Skelid) hypocalcemia

Major Potential Hazard, High plausibility. Applicable conditions: Vitamin D Deficiency

The use of bisphosphonates is contraindicated for the treatment of osteoporosis in patients with hypocalcemia. These agents increase bone mineral density, a process that requires an adequate supply of calcium in the body. Following the initiation of therapy, a short-term reduction in serum calcium and phosphate levels usually occurs due to inhibition of bone resorption, especially in patients with Paget's disease, in whom the pretreatment rate of bone turnover may be greatly elevated. Hypocalcemia and other disturbances of mineral metabolism, such as vitamin D deficiency, should be treated prior to initiation of therapy. Appropriate intake of calcium and vitamin D should be ensured throughout the course of treatment.

References

  1. "Product Information. Fosamax (alendronate)." Merck & Co, Inc, West Point, PA.
  2. Lourwood DL "The pharmacology and therapeutic utility of bisphosphonates." Pharmacotherapy 18 (1998): 779-89
  3. "Product Information. Actonel (risedronate)." Procter and Gamble Pharmaceuticals, Cincinnati, OH.
  4. Schussheim DH, Jacobs TP, Silverberg SJ "Hypocalcemia associated with alendronate." Ann Intern Med 130 (1999): 329
  5. Watts NB "Treatment of osteoporosis with bisphosphonates." Rheum Dis Clin North Am 20 (1994): 717-34
View all 5 references
Major

Bisphosphonates (applies to Skelid) upper GI mucosal irritation

Major Potential Hazard, High plausibility. Applicable conditions: Duodenitis/Gastritis, Dyspepsia, Dysphagia, Esophageal Disease, Peptic Ulcer

Bisphosphonates may cause local irritation of the upper gastrointestinal mucosa. Esophagitis and esophageal ulcers and erosions, occasionally with bleeding, as well as gastric and duodenal ulcers, have been reported, primarily with alendronate. Because of their structural similarities, therapy with all bisphosphonates should be administered cautiously in patients with active upper gastrointestinal disorders. The usual precautions should be followed closely to minimize the risk of irritation (i.e. taking the medication with a full glass of water after arising for the day and remaining upright for at least 30 minutes afterwards and until the first food intake of the day). Therapy should be discontinued if dysphagia, odynophagia or retrosternal pain occurs. The manufacturer of alendronate considers its use to be contraindicated in patients with abnormalities of the esophagus that may delay esophageal emptying, such as stricture or achalasia.

References

  1. Yue QY, Mortimer O "Alendronate - Risk for esophageal stricture." J Am Geriat Soc 46 (1998): 1581-2
  2. Rimmer DE, Rawls DE "Improper alendronate administration and a case of pill esophagitis." Am J Gastroenterol 91 (1996): 2648-9
  3. Nightingale SL "Important information regarding alendronate adverse reactions." JAMA 275 (1996): 1534
  4. Levine J, Nelson D "Esophageal stricture associated with alendronate therapy." Am J Med 102 (1997): 489-91
  5. Cameron RB "Esophagitis dissecans superficialis and alendronate: case report." Gastrointest Endosc 46 (1997): 562-3
  6. Degroen PC, Lubbe DF, Hirsch LJ, Daifotis A, Stephenson W, Freedholm D, Pryortillotson S, Seleznick MJ, Pinkas H, Wang KK "Esophagitis associated with the use of alendronate." N Engl J Med 335 (1996): 1016-21
  7. Lowe CE, Depew WT, Vanner SJ, Paterson WG, Meddings JB "Upper gastrointestinal toxicity of alendronate." Am J Gastroenterol 95 (2000): 634-40
  8. Colina RE, Smith M, Kikendall JW, Wong RK "A new probable increasing cause of esophageal ulceration: alendronate." Am J Gastroenterol 92 (1997): 704-6
  9. Wallace JL "Upper gastrointestinal ulceration with alendronate." Digest Dis Sci 44 (1999): 311-2
  10. Liberman UA, Hirsch LJ "Esophagitis and alendronate." N Engl J Med 335 (1996): 1069-70
  11. Lourwood DL "The pharmacology and therapeutic utility of bisphosphonates." Pharmacotherapy 18 (1998): 779-89
  12. Abdelmalek MF, Douglas DD "Alendronate-induced ulcerative esophagitis." Am J Gastroenterol 91 (1996): 1282-3
  13. "Product Information. Fosamax (alendronate)." Merck & Co, Inc, West Point, PA.
  14. Maconi G, Porro GB "Multiple ulcerative esophagitis caused by alendronate." Am J Gastroenterol 90 (1995): 1889-90
  15. Bauer DC, Black D, Ensrud K, Thompson D, Hochberg M, Nevitt M, Musliner T, Freedholm D "Upper gastrointestinal tract safety profile of alendronate - The Fracture Intervention Trial." Arch Intern Med 160 (2000): 517-25
  16. Peter CP "Upper gastrointestinal ulceration with alendronate - Response." Digest Dis Sci 44 (1999): 312-3
  17. Castell DO ""Pill esophagitis"--the case of alendronate." N Engl J Med 335 (1996): 1058-9
View all 17 references
Moderate

Tiludronate (applies to Skelid) renal dysfunction

Moderate Potential Hazard, Moderate plausibility.

Tiludronate is primarily eliminated by the kidney. The plasma half-life of the drug is prolonged in patients with impaired renal function. Tiludronate is not recommended for use in patients with creatinine clearance less than 30 mL/min due to a lack of clinical experience in this setting. No dosage adjustment is necessary in patients with mild to moderate renal impairment (CrCl >= 30 mL/min).

References

  1. Sansom LN, Necciari J, Thiercelin JF "Human pharmacokinetics of tiludronate." Bone 17 (1995): s479-83
  2. Schwietert HR, Peeters PA, Dingemanse J, Thiercelin JF, Necciari J, de Bruin H, Jonkman JH "Multiple dose pharmacokinetics of tiludronate in healthy volunteers." Eur J Clin Pharmacol 51 (1996): 175-81
  3. "Product Information. Skelid (tilundronate)." Sanofi Winthrop Pharmaceuticals, New York, NY.

Skelid (tiludronate) drug interactions

There are 99 drug interactions with Skelid (tiludronate)

Skelid (tiludronate) alcohol/food interactions

There are 2 alcohol/food interactions with Skelid (tiludronate)

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

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.