Drug Interactions between cholecalciferol / iron polysaccharide and etidronate

Food, especially calcium-containing food such as dairy products, significantly decreases the absorption of etidronate. For at least the first 2 hours after taking etidronate, do not eat or drink anything other than plain water, and do not take any other medicines including vitamins or mineral supplements which are high in metals such as calcium, iron, magnesium, or aluminum. Use only plain water (not mineral water) when taking etidronate tablets.

Treatment with cholecalciferol may require you to adjust your dietary intake of foods which contain natural or added calcium, phosphate (organic and inorganic), and vitamin D. Ingesting too much vitamin D or having elevated calcium and/or phosphorus levels in the blood and urine can lead to toxic effects, such as having an irregular heart rhythm, seizures, kidney stones, and eventual calcification of your blood vessels, cornea and/or the soft tissues in your body. Your doctor will monitor the levels of calcium and phosphorus in your blood during treatment with cholecalciferol. Please speak with your healthcare team to determine if you require a specialized diet, particularly if you have reduced kidney function, and to discuss any other questions or concerns you have. You may require additional monitoring or a dose adjustment of cholecalciferol if your diet changes. Fortified foods will state on their labeling how much calcium, phosphate, and/or vitamin D has been added. The National Institutes of Health, Office of Dietary Supplements also provides information on which foods contain calcium, phosphorus, and vitamin D. You should avoid abrupt changes in your dietary calcium intake and seek medical attention if you experience early symptoms of vitamin D intoxication such as weakness, fatigue, headache, drowsiness, vertigo, ringing in the ears, loss of appetite, nausea, vomiting, constipation, dry mouth, metallic taste, muscle pain, bone pain, muscle incoordination, and low muscle tone. Late symptoms may include frequent urination, excessive thirst, weight loss, conjunctivitis ("pink eye"), light sensitivity, runny nose, itching, increased body temperature, and irregular heart rhythm. 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.

Food may reduce the absorption and blood levels of iron polysaccharide. In addition, some oral medications can also interfere with iron polysaccharide absorption into the bloodstream, which may make the medication less effective in treating your condition. Likewise, iron polysaccharide may interfere with the absorption of other orally administered medications. You should take iron polysaccharide on an empty stomach at least one hour before or two hours after a meal. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. Talk to your doctor or pharmacist if you have questions about 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.

Etidronate and multivitamin with minerals 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 etidronate into the bloodstream and reduce its effectiveness. You should take multivitamin with minerals at least 2 hours before or 2 hours after the etidronate 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.