Skip to main content

Drug Interactions between Actonel with Calcium and baloxavir marboxil

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

Edit list (add/remove drugs)

Interactions between your drugs

Moderate

calcium carbonate risedronate

Applies to: Actonel with Calcium (calcium carbonate / risedronate) and Actonel with Calcium (calcium carbonate / risedronate)

ADJUST DOSING INTERVAL: Products containing aluminum, calcium, magnesium and other polyvalent cations such as antacids or vitamin with mineral supplements are likely to interfere with the gastrointestinal absorption of oral bisphosphonates. For example, the bioavailability of tiludronate has been shown to decrease 80% during simultaneous administration with calcium, and 60% when aluminum- or magnesium-containing antacids were administered one hour before tiludronate.

MANAGEMENT: Antacids or other oral medications containing aluminum, calcium, magnesium and other polyvalent cations should be administered at least 30 minutes after the bisphosphonate dose.

References (6)
  1. (2001) "Product Information. Fosamax (alendronate)." Merck & Co., Inc
  2. Darcy PF (1995) "Nutrient-drug interactions." Adverse Drug React Toxicol Rev, 14, p. 233-54
  3. "Product Information. Skelid (tiludronate)." Sanofi Winthrop Pharmaceuticals
  4. (2001) "Product Information. Actonel (risedronate)." Procter and Gamble Pharmaceuticals
  5. (2001) "Product Information. Bonefos (clodronate)." Rhone-Poulenc Rorer Canada Inc
  6. (2005) "Product Information. Boniva (ibandronate)." Roche Laboratories
Moderate

calcium carbonate baloxavir marboxil

Applies to: Actonel with Calcium (calcium carbonate / risedronate) and baloxavir marboxil

GENERALLY AVOID: Coadministration with polyvalent cation-containing products may decrease the plasma concentrations and therapeutic efficacy of baloxavir. The proposed mechanism is chelation of baloxavir by polyvalent cations, forming a complex that is poorly absorbed from the gastrointestinal tract. A significant decrease in baloxavir exposure was observed in monkeys when the prodrug, baloxavir marboxil, was coadministered with calcium, aluminum, magnesium, or iron. However, clinical data in humans are lacking.

MANAGEMENT: Concurrent administration of baloxavir marboxil with polyvalent cation-containing laxatives, antacids, or oral supplements (e.g., aluminum, calcium, iron, magnesium, selenium, zinc) should generally be avoided.

References (1)
  1. (2018) "Product Information. Xofluza (baloxavir marboxil)." Genentech

Drug and food interactions

Moderate

calcium carbonate food

Applies to: Actonel with Calcium (calcium carbonate / risedronate)

ADJUST DOSING INTERVAL: Administration with food may increase the absorption of calcium. However, foods high in oxalic acid (spinach or rhubarb), or phytic acid (bran and whole grains) may decrease calcium absorption.

MANAGEMENT: Calcium may be administered with food to increase absorption. Consider withholding calcium administration for at least 2 hours before or after consuming foods high in oxalic acid or phytic acid.

References (6)
  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  2. Canadian Pharmacists Association (2006) e-CPS. http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink
  3. Cerner Multum, Inc. "Australian Product Information."
  4. Agencia Española de Medicamentos y Productos Sanitarios Healthcare (2008) Centro de información online de medicamentos de la AEMPS - CIMA. https://cima.aemps.es/cima/publico/home.html
  5. Mangels AR (2014) "Bone nutrients for vegetarians." Am J Clin Nutr, 100, epub
  6. Davies NT (1979) "Anti-nutrient factors affecting mineral utilization." Proc Nutr Soc, 38, p. 121-8
Moderate

risedronate food

Applies to: Actonel with Calcium (calcium carbonate / 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)
  1. (2001) "Product Information. Actonel (risedronate)." Procter and Gamble Pharmaceuticals
Moderate

baloxavir marboxil food

Applies to: baloxavir marboxil

GENERALLY AVOID: Coadministration with foods or medications that contain polyvalent cations such as dairy products, calcium-fortified beverages, certain laxatives, antacids, or oral supplements may decrease the plasma concentrations and therapeutic efficacy of baloxavir. The proposed mechanism is chelation of baloxavir by polyvalent cations, forming a complex that is poorly absorbed from the gastrointestinal tract. A significant decrease in baloxavir exposure was observed in monkeys when the prodrug, baloxavir marboxil, was coadministered with calcium, aluminum, magnesium, or iron. However, clinical data in humans are lacking.

When baloxavir marboxil was administered with food, baloxavir peak plasma concentration (Cmax) and systemic exposure (AUC) decreased by 48% and 36%, respectively, relative to administration under fasting. These changes are not considered clinically significant.

MANAGEMENT: Baloxavir marboxil may be taken with or without food. However, coadministration with dairy products, calcium-fortified beverages, or polyvalent cation-containing laxatives, antacids, or oral supplements (e.g., calcium, iron, magnesium, selenium, or zinc) should be avoided.

References (2)
  1. Cerner Multum, Inc. "Australian Product Information."
  2. (2018) "Product Information. Xofluza (baloxavir marboxil)." Genentech

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

Report options

Loading...
QR code containing a link to this page

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.

Medical Disclaimer