Drug Interactions between etidronate and lenvatinib

Lenvatinib can cause a rare but serious condition known as osteonecrosis of the jaw (ONJ), and combining it with etidronate may increase the risk. ONJ is the exposure of jaw bone through the gums associated with death of bone tissue and usually occurs after invasive dental procedures such as tooth extraction. The risk is generally related to the dose of these medications and the duration of treatment. Good oral hygiene accompanied by regular dental care is the best way to lower the risk of ONJ. Talk to your doctor and dentist if you have any questions or concerns. Your healthcare provider may already be aware of the risks but has determined that this is the best course of treatment for you. Your doctor and/or dentist may monitor your dental health more closely for any potential complications. You should seek medical attention if you experience potential signs and symptoms of ONJ such as: pain in the mouth, teeth, or jaw; swelling or sores inside the mouth; numbness or a feeling of heaviness in the jaw; loosening of a tooth; or exposure of bone in the jaw. Also, before you get any type of dental surgery, be sure to let your care provider know you are taking these medications.

lenvatinib may cause kidney problems, and combining it with a bisphosphonate medication that is given intravenously, such as ibandronate (Boniva), pamidronate (Aredia), or zoledronic acid (Reclast) may increase that risk. Lenvatinib as well as etidronate have also been associated with low calcium levels. Talk to your doctor if you have any questions or concerns. 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. You should seek immediate medical attention if you develop signs and symptoms that may suggest kidney damage or low calcium levels such as nausea, vomiting, loss of appetite, increased or decreased urination, sudden weight gain or weight loss, fluid retention, swelling, shortness of breath, bone pain, muscle cramps or spasms, twitching muscles, tiredness, weakness, dizziness, confusion, irregular heart rhythm and/or numbness or tingling in the feet, hands, or around the mouth. Be sure to drink plenty of fluids if you develop diarrhea or vomiting during treatment with these medications, as dehydration can also affect the kidney. 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.