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Tiludronate Disease Interactions

There are 3 disease interactions with tiludronate.

Major

Bisphosphonates (applies to tiludronate) 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 (7)
  1. Watts NB (1994) "Treatment of osteoporosis with bisphosphonates." Rheum Dis Clin North Am, 20, p. 717-34
  2. (2001) "Product Information. Fosamax (alendronate)." Merck & Co., Inc
  3. (2001) "Product Information. Actonel (risedronate)." Procter and Gamble Pharmaceuticals
  4. Lourwood DL (1998) "The pharmacology and therapeutic utility of bisphosphonates." Pharmacotherapy, 18, p. 779-89
  5. Schussheim DH, Jacobs TP, Silverberg SJ (1999) "Hypocalcemia associated with alendronate." Ann Intern Med, 130, p. 329
  6. (2005) "Product Information. Boniva (ibandronate)." Roche Laboratories
  7. (2011) "Product Information. Reclast (zoledronic acid)." Quality Care Products/Lake Erie Medical
Major

Bisphosphonates (applies to tiludronate) 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 (19)
  1. Maconi G, Porro GB (1995) "Multiple ulcerative esophagitis caused by alendronate." Am J Gastroenterol, 90, p. 1889-90
  2. (2001) "Product Information. Fosamax (alendronate)." Merck & Co., Inc
  3. Nightingale SL (1996) "Important information regarding alendronate adverse reactions." JAMA, 275, p. 1534
  4. Abdelmalek MF, Douglas DD (1996) "Alendronate-induced ulcerative esophagitis." Am J Gastroenterol, 91, p. 1282-3
  5. Castell DO (1996) ""Pill esophagitis"--the case of alendronate." N Engl J Med, 335, p. 1058-9
  6. Liberman UA, Hirsch LJ (1996) "Esophagitis and alendronate." N Engl J Med, 335, p. 1069-70
  7. Degroen PC, Lubbe DF, Hirsch LJ, Daifotis A, Stephenson W, Freedholm D, Pryortillotson S, Seleznick MJ, Pinkas H, Wang KK (1996) "Esophagitis associated with the use of alendronate." N Engl J Med, 335, p. 1016-21
  8. (2001) "Product Information. Actonel (risedronate)." Procter and Gamble Pharmaceuticals
  9. Colina RE, Smith M, Kikendall JW, Wong RK (1997) "A new probable increasing cause of esophageal ulceration: alendronate." Am J Gastroenterol, 92, p. 704-6
  10. Rimmer DE, Rawls DE (1996) "Improper alendronate administration and a case of pill esophagitis." Am J Gastroenterol, 91, p. 2648-9
  11. Levine J, Nelson D (1997) "Esophageal stricture associated with alendronate therapy." Am J Med, 102, p. 489-91
  12. Cameron RB (1997) "Esophagitis dissecans superficialis and alendronate: case report." Gastrointest Endosc, 46, p. 562-3
  13. Lourwood DL (1998) "The pharmacology and therapeutic utility of bisphosphonates." Pharmacotherapy, 18, p. 779-89
  14. Yue QY, Mortimer O (1998) "Alendronate - Risk for esophageal stricture." J Am Geriat Soc, 46, p. 1581-2
  15. Wallace JL (1999) "Upper gastrointestinal ulceration with alendronate." Digest Dis Sci, 44, p. 311-2
  16. Peter CP (1999) "Upper gastrointestinal ulceration with alendronate - Response." Digest Dis Sci, 44, p. 312-3
  17. Bauer DC, Black D, Ensrud K, Thompson D, Hochberg M, Nevitt M, Musliner T, Freedholm D (2000) "Upper gastrointestinal tract safety profile of alendronate - The Fracture Intervention Trial." Arch Intern Med, 160, p. 517-25
  18. Lowe CE, Depew WT, Vanner SJ, Paterson WG, Meddings JB (2000) "Upper gastrointestinal toxicity of alendronate." Am J Gastroenterol, 95, p. 634-40
  19. (2005) "Product Information. Boniva (ibandronate)." Roche Laboratories
Moderate

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

Switch to consumer interaction data

Tiludronate drug interactions

There are 112 drug interactions with tiludronate.

Tiludronate alcohol/food interactions

There are 2 alcohol/food interactions with tiludronate.

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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.

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