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Drug Interactions between Fosamax and Prolia

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

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Interactions between your drugs

Moderate

alendronate denosumab

Applies to: Fosamax (alendronate) and Prolia (denosumab)

Both denosumab and alendronate can cause a rare but serious condition known as osteonecrosis of the jaw (ONJ), and combining these medications 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. Severe cases may require surgery. The risk is generally related to the dose of these medications and the duration of treatment. Because alendronate can remain in the bone for years, the risk may exist for some time even after you have stopped taking it. Good oral hygiene and regular dental care is the best way to lower the risk of ONJ. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you 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. 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.

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Drug and food interactions

Moderate

alendronate food

Applies to: Fosamax (alendronate)

Food may reduce the absorption of alendronate, which may lead to lower blood levels of the medication and possibly reduced effectiveness. You should take alendronate first thing in the morning, at least 30 minutes before you eat or drink anything or take any other medication. Take each dose with a full glass (6 to 8 ounces) of water, and use only plain water (not mineral or vitamin water). Do not take alendronate if you cannot sit upright or stand for at least 30 minutes. Because alendronate can cause irritation and ulcer in the stomach or esophagus (the tube that connects your mouth and stomach), you will need to stay upright for at least 30 minutes after taking this medication. Talk to your doctor or pharmacist 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.

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Therapeutic duplication warnings

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

Duplication

Bone resorption inhibitors

Therapeutic duplication

The recommended maximum number of medicines in the 'bone resorption inhibitors' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'bone resorption inhibitors' category:

  • Fosamax (alendronate)
  • Prolia (denosumab)

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.

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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

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer