Drug Interactions between Didronel IV and lanthanum carbonate

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.

GENERALLY AVOID: Lanthanum carbonate should be administered with food for therapeutic efficacy. However, it is insoluble in water (<0.01 mg/mL at pH 7.5) and therefore cannot be dissolved in liquid for administration through an enteral feeding tube, because it may result in blockage of the tube.

MANAGEMENT: Administration of lanthanum carbonate with enteral feedings is not recommended. Alternative medications such as calcium carbonate suspension should be considered.

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.