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Drug Interactions between Baraclude and Didronel IV

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

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Interactions between your drugs

Moderate

etidronate entecavir

Applies to: Didronel IV (etidronate) and Baraclude (entecavir)

MONITOR: Because entecavir is primarily eliminated by renal excretion, coadministration with drugs that affect renal function may alter the plasma concentrations of entecavir and/or the coadministered drug. In patients with renal impairment, the apparent oral clearance of entecavir has been shown to decrease as the creatinine clearance decreases. In a small pilot study consisting of nine liver transplant recipients on a stable dose of cyclosporine or tacrolimus, entecavir exposure was approximately 2-fold that in healthy subjects with normal renal function. Altered renal function contributed to the increase in entecavir exposure in these patients.

MANAGEMENT: Caution is advised if entecavir is prescribed in combination with potentially nephrotoxic drugs (e.g., aminoglycosides; polypeptide, glycopeptide, and polymyxin antibiotics; amphotericin B; adefovir; cidofovir; tenofovir; foscarnet; cisplatin; deferasirox; gallium nitrate; lithium; mesalamine; certain immunosuppressants; intravenous bisphosphonates; intravenous pentamidine; high intravenous dosages of methotrexate; high dosages and/or chronic use of nonsteroidal anti-inflammatory agents). Renal function should be evaluated prior to and during therapy with entecavir. Dosage adjustment is required in patients with renal insufficiency (creatinine clearance below 50 mL/min) at baseline or during treatment in accordance with the manufacturer's product labeling.

References

  1. "Product Information. Baraclude (entecavir)." Bristol-Myers Squibb (2005):

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Drug and food interactions

Moderate

etidronate food

Applies to: Didronel IV (etidronate)

ADJUST DOSING INTERVAL: Food, especially calcium-containing food such as dairy products, significantly decreases the bioavailability of oral etidronate.

MANAGEMENT: Oral etidronate should be administered on an empty stomach and no other food or drink should be taken within least 2 hours of administration.

References

  1. "Product Information. Didronel (etidronate)." Procter and Gamble Pharmaceuticals (2022):
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

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Moderate

entecavir food

Applies to: Baraclude (entecavir)

ADJUST DOSING INTERVAL: Food delays the oral absorption and reduces the oral bioavailability of entecavir. According to the product labeling, administration of entecavir 0.5 mg with a standard high-fat meal or a light meal resulted in a delay in absorption by 0.25 to 0.75 hours, a decrease in the peak plasma concentration (Cmax) by 44% to 46%, and a decrease in the area under the plasma concentration-time curve (AUC) by 18% to 20% compared to administration in the fasting state.

MANAGEMENT: To ensure maximal oral absorption, entecavir should be administered on an empty stomach at least 2 hours after a meal and 2 hours before the next meal.

References

  1. "Product Information. Baraclude (entecavir)." Bristol-Myers Squibb (2005):

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Moderate

etidronate food

Applies to: Didronel IV (etidronate)

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 2 hours before or 2 hours after the bisphosphonate dose.

References

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

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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.

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