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Drug Interactions between Boniva and Penthrane

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

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Interactions between your drugs

Moderate

methoxyflurane ibandronate

Applies to: Penthrane (methoxyflurane) and Boniva (ibandronate)

MONITOR: Coadministration of bisphosphonates with other nephrotoxic agents may increase the risk and severity of renal impairment due to additive effects on the kidney. The use of bisphosphonates has been associated with nephrotoxicity manifested as deterioration of renal function and renal failure. Cases have primarily involved intravenous formulations of the drugs such as pamidronate and zoledronic acid, especially when they are administered too rapidly. The risk of hypocalcemia may also be increased, as drug-induced renal tubular damage can lead to renal loss of calcium and other electrolytes such as magnesium. Bisphosphonates alone often cause mild, asymptomatic hypocalcemia via inhibitive effects on bone resorption and possibly chelation of blood calcium.

MANAGEMENT: Caution is advised if pamidronate, zoledronic acid, or other intravenous formulations of bisphosphonates must be used in patients who have recently received or are receiving treatment with other potentially nephrotoxic agents (e.g., aminoglycosides, polypeptide and polymyxin antibiotics, vancomycin, amphotericin B, adefovir, cidofovir, tenofovir, foscarnet, cisplatin, gallium nitrate, lithium, mesalamine, certain immunosuppressants, intravenous pentamidine, high intravenous dosages of methotrexate, high dosages of nonsteroidal anti-inflammatory agents). Renal function and serum electrolytes should be monitored. Patients should have serum creatinine assessed prior to each treatment, and treatment should be withheld for renal deterioration. In those treated for bone metastases, treatment should not be resumed until renal function returns to baseline.

References

  1. Kanis JA, Preston CJ, Yates AJ, Percival RC, Mundy KI, Russell RG (1983) "Effects of intravenous diphosphonates on renal function." Lancet, 1, p. 1328
  2. (2001) "Product Information. Aredia (pamidronate)." Novartis Pharmaceuticals
  3. Osullivan TL, Akbari A, Cadnapaphornchai P (1994) "Acute renal failure associated with the administration of parenteral etidronate." Ren Fail, 16, p. 767-73
  4. Zazgornik J, Grafinger P, Biesenbach G, Hubmann R, Fridrik M (1997) "Acute renal failure and alendronate." Nephrol Dial Transplant, 12, p. 2797-8
  5. (2001) "Product Information. Zometa (zoledronic acid)." Novartis Pharmaceuticals
  6. Janssen Van Doorn K, Neyns B, Van Der Niepen P, Verbeelen D (2001) "Pamidronate-related nephrotoxicity (tubulointerstitial nephritis) in a patient with osteolytic bone metastases." Nephron, 89, p. 467-8
  7. Lockridge L, Papac RJ, Perazella MA (2002) "Pamidronate-associated nephrotoxicity in a patient with Langerhans's histiocytosis." Am J Kidney Dis, 40, E2
  8. Markowitz GS, Fine PL, Stack JI, et al. (2003) "Toxic acute tubular necrosis following treatment with zoledronate (Zometa)." Kidney Int, 64, p. 281-289
  9. Banerjee D, Asif A, Striker L, Preston RA, Bourgoignie JJ, Roth D (2003) "Short-term, high-dose pamidronate-induced acute tubular necrosis: The postulated mechanisms of bisphosphonate nephrotoxicity." Am J Kidney Dis, 41, E18
  10. Chang JT, Green L, Beitz J (2003) "Renal failure with the use of zoledronic acid." N Engl J Med, 349, 1676-9; discussion 1676-9
  11. (2004) "Product Information. Ostac (clodronate)." Hoffmann-La Roche Limited
  12. (2005) "Product Information. Boniva (ibandronate)." Roche Laboratories
View all 12 references

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Drug and food interactions

Moderate

ibandronate food

Applies to: Boniva (ibandronate)

ADJUST DOSING INTERVAL: Food significantly decreases the bioavailability of oral ibandronate. The manufacturer reports up to a 75% decrease in bioavailability when administered 2 hours after a standard meal.

MANAGEMENT: Oral ibandronate should be administered on an empty stomach (after an overnight fast of at least 6 hours) with a 180 to 240 mL glass of plain water and no other food or drink should be taken for at least 30 minutes after administration.

References

  1. (2005) "Product Information. Boniva (ibandronate)." Roche Laboratories
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  3. Cerner Multum, Inc. "Australian Product Information."

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Moderate

methoxyflurane food

Applies to: Penthrane (methoxyflurane)

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of central nervous system (CNS)-active agents. Use in combination may result in additive CNS depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled against driving, operating machinery, or engaging in potentially hazardous activities requiring mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

References

  1. Warrington SJ, Ankier SI, Turner P (1986) "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology, 15, p. 31-7
  2. Gilman AG, eds., Nies AS, Rall TW, Taylor P (1990) "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc.
  3. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  4. (2012) "Product Information. Fycompa (perampanel)." Eisai Inc
  5. (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc
View all 5 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

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