Drug Interactions between Copper 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.

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.

Etidronate administered orally may cause local irritation of the upper gastrointestinal mucosa. Its use is contraindicated in patients with esophageal abnormalities that delay esophageal emptying such as achalasia or strictures. Etidronate should be used with caution in patients with active upper gastrointestinal problems, such as Barrett's esophagus, dysphagia, gastritis, duodenitis, ulcers, etc, as cases of erosions, bleeding and perforation have been reported. Patients should be instructed to discontinue treatment immediately and seek medical attention if they develop dysphagia, retrosternal pain, or new or worsening heartburn.

Etidronate administered orally may cause local irritation of the upper gastrointestinal mucosa. Its use is contraindicated in patients with esophageal abnormalities that delay esophageal emptying such as achalasia or strictures. Etidronate should be used with caution in patients with active upper gastrointestinal problems, such as Barrett's esophagus, dysphagia, gastritis, duodenitis, ulcers, etc, as cases of erosions, bleeding and perforation have been reported. Patients should be instructed to discontinue treatment immediately and seek medical attention if they develop dysphagia, retrosternal pain, or new or worsening heartburn.

Etidronate administered orally may cause local irritation of the upper gastrointestinal mucosa. Its use is contraindicated in patients with esophageal abnormalities that delay esophageal emptying such as achalasia or strictures. Etidronate should be used with caution in patients with active upper gastrointestinal problems, such as Barrett's esophagus, dysphagia, gastritis, duodenitis, ulcers, etc, as cases of erosions, bleeding and perforation have been reported. Patients should be instructed to discontinue treatment immediately and seek medical attention if they develop dysphagia, retrosternal pain, or new or worsening heartburn.

The use of etidronate (for the treatment of Paget's disease or the treatment/prevention of heterotopic ossification) is contraindicated in patients with clinically overt osteomalacia. Etidronate can inhibit bone mineralization, which has resulted in osteomalacia and bone fractures in some patients. Accumulation of unmineralized osteoid is usually noticeable during prolonged, continuous use of high dosages (10 to 20 mg/kg/day) but may occur at lower dosages when use exceeds 6 months. The newer bisphosphonates (e.g., alendronate, pamidronate, risedronate, and tiludronate) do not cause mineralization defects and may be more appropriate for patients with osteomalacia, although clinical data may be lacking for the treatment of some conditions for which etidronate is used.

The trace elements, copper and manganese, are excreted in the bile. Copper and manganese doses may need to be adjusted, reduced, or omitted in patients with liver disease or biliary obstruction.

The trace elements, copper and manganese, are excreted in the bile. Copper and manganese doses may need to be adjusted, reduced, or omitted in patients with liver disease or biliary obstruction.

The trace metals manganese, chromium, copper, selenium, and zinc are absorbed in the GI tract from dietary sources and following administration of oral supplements. GI absorption may be decreased in patients with malabsorption syndromes. Therefore, larger dosages may be required when these supplements are given orally. Parenteral administration may be appropriate.

Etidronate is eliminated intact by the kidney. There is no experience to specifically make recommendations in patients with impaired renal function. Etidronate dosage should be reduced when reductions in glomerular filtration rates are present. Patients with renal impairment should be closely monitored.