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Drug Interactions between Actonel with Calcium and vadadustat

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

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Interactions between your drugs

Major

calcium carbonate vadadustat

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

Consumer information for this interaction is not currently available.

ADJUST DOSING INTERVAL: Coadministration of vadadustat with oral products containing multivalent cations such as calcium, magnesium, or aluminum may significantly decrease the bioavailability of vadadustat. The mechanism of this interaction has not been fully described but may involve the formation of an insoluble complex or chelate with multivalent cations that is poorly absorbed from the gastrointestinal tract. According to product labeling, when non-iron-containing phosphate binders were coadministered-administered with vadadustat, the systemic exposure (AUC) and peak plasma concentration (Cmax) decreased by 55% and 52%, respectively.

MANAGEMENT: Vadadustat should be administered at least one hour before, or two hours after the administration of oral non-iron-containing phosphate binders or other medicinal products whose primary component consists of multivalent cations such as calcium, magnesium, or aluminum.

Moderate

calcium carbonate risedronate

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

Risedronate and calcium carbonate should not be taken orally at the same time. Products that contain magnesium, aluminum, calcium, iron, and/or other minerals may interfere with the absorption of risedronate into the bloodstream and reduce its effectiveness. You should take calcium carbonate at least 30 minutes after the risedronate dose. Talk to a healthcare professional if you are not sure whether a product contains something that could potentially interact with your medication or if you have questions on how to take this or other medications you are prescribed. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Moderate

risedronate vadadustat

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

Consumer information for this interaction is not currently available.

MONITOR: Coadministration of hypoxia-inducible factor prolyl hydroxylase (HIF PH) inhibitors, such as vadadustat or daprodustat, with drugs that are known to increase the risk of gastrointestinal erosion may increase the risk of gastric or esophageal erosions. Serious erosions, including gastrointestinal bleeding and the need for red blood cell transfusions, were reported during vadadustat and daprodustat clinical trials. Patients with a history of gastrointestinal erosion, peptic ulcer disease, and current tobacco smokers and alcohol drinkers may be at higher risk of gastrointestinal injury.

MANAGEMENT: Caution is advised if vadadustat or daprodustat are coadministered with drugs that have a known risk of gastrointestinal erosion, including but not limited to NSAIDs, corticosteroids, oral bisphosphonates, oral potassium formulations, anticoagulants as well as certain chemotherapeutic agents (e.g., kinase inhibitors) and antibiotics. Patients should be advised to contact their physician if they develop potential signs and symptoms of gastrointestinal injury such as abdominal pain, hematemesis, trouble swallowing, chest or throat pain, and/or black, tarry stools.

Drug and food interactions

Moderate

calcium carbonate food

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

Calcium absorption may be increased by taking it with food. However, foods high in oxalic acid (spinach or rhubarb), or phytic acid (bran and whole grains) may decrease calcium absorption. Calcium may be taken with food to increase absorption. Consider spacing calcium administration for at least 2 hours before or after consuming foods high in oxalic acid or phytic acid. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Moderate

risedronate food

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

Food may reduce the absorption of risedronate, which may lead to lower blood levels of the medication and possibly reduced effectiveness. You should take risedronate first thing in the morning, at least 30 minutes before you eat or drink anything or take any other medication. Take each dose with a full glass (6 to 8 ounces) of water, and use only plain water (not mineral or vitamin water). Do not take risedronate if you cannot sit upright or stand for at least 30 minutes. Because risedronate can cause irritation and ulcer in the stomach or esophagus (the tube that connects your mouth and stomach), you will need to stay upright for at least 30 minutes after taking this medication. Talk to your doctor or pharmacist if you have questions on how to take this or other medications you are prescribed. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Moderate

vadadustat food

Applies to: vadadustat

Consumer information for this interaction is not currently available.

MONITOR: Smoking and alcohol consumption during therapy with vadadustat may increase the risk of gastrointestinal erosions. Serious erosions, including gastrointestinal bleeding and the need for red blood cell transfusions, have been reported during vadadustat clinical trials. Patients with a history of gastrointestinal erosion, peptic ulcer disease, and current tobacco smokers and alcohol drinkers may be at higher risk of gastrointestinal injury.

MANAGEMENT: Caution is advised if vadadustat is prescribed to current tobacco smokers or alcohol drinkers. Patients should be advised to contact their physician if they develop potential signs and symptoms of gastrointestinal injury such as abdominal pain, hematemesis, trouble swallowing, chest or throat pain, and/or black, tarry stools.

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.


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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

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