Skelid (tiludronate) Disease Interactions
There are 3 disease interactions with Skelid (tiludronate):
Bisphosphonates (Includes Skelid) ↔ Hypocalcemia
Severe Potential Hazard, High plausibility
Applies to: Hypocalcemia, 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.
- Lourwood DL "The pharmacology and therapeutic utility of bisphosphonates." Pharmacotherapy 18 (1998): 779-89
- Schussheim DH, Jacobs TP, Silverberg SJ "Hypocalcemia associated with alendronate." Ann Intern Med 130 (1999): 329
- Watts NB "Treatment of osteoporosis with bisphosphonates." Rheum Dis Clin North Am 20 (1994): 717-34
Bisphosphonates (Includes Skelid) ↔ Upper Gi Mucosal Irritation
Severe Potential Hazard, High plausibility
Applies to: 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.
- Yue QY, Mortimer O "Alendronate - Risk for esophageal stricture." J Am Geriat Soc 46 (1998): 1581-2
- "Product Information. Fosamax (alendronate)." Merck & Co, Inc, West Point, PA.
- Levine J, Nelson D "Esophageal stricture associated with alendronate therapy." Am J Med 102 (1997): 489-91
Tiludronate (Includes Skelid) ↔ Renal Dysfunction
Moderate Potential Hazard, Moderate plausibility
Applies to: Renal Dysfunction
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).
- Sansom LN, Necciari J, Thiercelin JF "Human pharmacokinetics of tiludronate." Bone 17 (1995): s479-83
- 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
- "Product Information. Skelid (tilundronate)." Sanofi Winthrop Pharmaceuticals, New York, NY.
Skelid (tiludronate) drug Interactions
There are 214 drug interactions with Skelid (tiludronate)
Skelid (tiludronate) alcohol/food Interactions
There are 2 alcohol/food interactions with Skelid (tiludronate)
Drug Interaction Classification
The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
|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.|
Do not stop taking any medications without consulting your healthcare provider.
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