Interactions between Ospomyv and Pamidronate
1 drug interaction and 9 additional warnings found for the following 2 drugs:
- Ospomyv (denosumab)
- pamidronate
Drug interactions
Moderate drug interactions
Moderate:
pamidronate denosumab
Applies to: pamidronate and Ospomyv (denosumab)
Monitor
Osteonecrosis of the jaw (ONJ) has been reported with the use of angiogenesis inhibitors including denosumab, bevacizumab, and sunitinib. Concomitant exposure with other risk factors such as bisphosphonates (potency, route of administration, and cumulative dose), cancer, chemotherapy, corticosteroids, radiotherapy to the head and neck, dental disease, invasive dental procedures, or poor oral hygiene may increase the risk. Most reported cases with bevacizumab have occurred in patients who received prior or concomitant treatment with intravenous bisphosphonates or had a history of dental disease requiring invasive dental procedures. For denosumab, the majority of reported cases of ONJ in clinical trials occurred within 5 months after the last dose; in clinical trials, the incidence increased with duration of exposure. Clinical trials in patients with breast or prostate cancer with an extension treatment phase of open-label denosumab reported a patient-year adjusted incidence of confirmed ONJ of 1.1% in the first year of treatment, 3.7% in the second year, and 4.6% thereafter, with a median time to ONJ onset of approximately 20.6 months. ONJ has been rarely reported in clinical trials with the use of denosumab for osteoporosis.
Management
Caution is advised if bisphosphonates are used simultaneously or sequentially with denosumab or bevacizumab. Prior to initiating treatment, a thorough dental examination and appropriate preventive dentistry should be considered. If possible, invasive dental procedures should be avoided in patients who have previously received or are receiving intravenous bisphosphonates. Good oral hygiene practices should be maintained during treatment. Patients should be advised to seek medical attention if they experience signs and symptoms of osteonecrosis in the jaw, 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. Temporary interruption of treatment should be considered if clinically appropriate, until the condition resolves.
References (4)
- (2006) "Product Information. Sutent (sunitinib)." Pfizer U.S. Pharmaceuticals Group
- Cerner Multum, Inc. "UK Summary of Product Characteristics."
- Cerner Multum, Inc. "Australian Product Information."
- (2010) "Product Information. Prolia (denosumab)." Amgen Inc
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.
It can be intentional, when combining drugs with similar actions adds demonstrated therapeutic benefit — or unintentional, such as when a patient sees multiple prescribers or fills prescriptions at more than one pharmacy, which can lead to adverse effects.
Duplication:
Bone resorption inhibitors
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:
- Ospomyv (denosumab)
- pamidronate
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.
Food/lifestyle interactions
No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.
Disease interactions
8 potential interactions Applies to: 6 conditions, including Hypocalcemia, Hypoparathyroidism, Thyroid Disease, Immunodeficiency, and Renal Dysfunction.
Electrolyte Abnormalities
Moderate:
pamidronate
Pamidronate has a moderate potential interaction with Electrolyte Abnormalities.
Standard hypercalcemia- related metabolic parameters, such as serum levels of calcium, phosphate, magnesium, and potassium, should be carefully monitored following initiation of therapy with pamidronate. Cases of asymptomatic hypophosphatemia, hypokalemia, hypomagnesemia, and hypocalcemia have been reported. Additionally, some rare cases of symptomatic hypocalcemia (including tetany), have been observed. Patients with a history of thyroid surgery may have relative hypoparathyroidism that may predispose to hypocalcemia with pamidronate.
Hypocalcemia
Major:
Ospomyv
The denosumab in Ospomyv has a major potential interaction with Hypocalcemia.
Preexisting hypocalcemia must be corrected prior to initiating treatment with denosumab. Caution should be exercised in patients predisposed to hypocalcemia and any disturbances of mineral metabolism, such as history of hypoparathyroidism, thyroid or parathyroid surgery, malabsorption syndromes, excision of small intestine, severe renal impairment or dialysis. Clinical monitoring of calcium and mineral levels (phosphorus and magnesium) are highly recommended within 14 days of denosumab injection. It is important to maintain calcium levels with adequate calcium and vitamin D supplementation.
Hypoparathyroidism
Major:
Ospomyv
The denosumab in Ospomyv has a major potential interaction with Hypoparathyroidism.
Preexisting hypocalcemia must be corrected prior to initiating treatment with denosumab. Caution should be exercised in patients predisposed to hypocalcemia and any disturbances of mineral metabolism, such as history of hypoparathyroidism, thyroid or parathyroid surgery, malabsorption syndromes, excision of small intestine, severe renal impairment or dialysis. Clinical monitoring of calcium and mineral levels (phosphorus and magnesium) are highly recommended within 14 days of denosumab injection. It is important to maintain calcium levels with adequate calcium and vitamin D supplementation.
Immunodeficiency
Moderate:
Ospomyv
The denosumab in Ospomyv has a moderate potential interaction with Immunodeficiency.
Denosumab should be used with caution in patients with impaired immune systems or taking concomitant immunosuppressant agents as they may be at increased risk for serious infections.
Renal Dysfunction
Major:
Ospomyv
The denosumab in Ospomyv has a major potential interaction with Renal Dysfunction.
Preexisting hypocalcemia must be corrected prior to initiating treatment with denosumab. Caution should be exercised in patients predisposed to hypocalcemia and any disturbances of mineral metabolism, such as history of hypoparathyroidism, thyroid or parathyroid surgery, malabsorption syndromes, excision of small intestine, severe renal impairment or dialysis. Clinical monitoring of calcium and mineral levels (phosphorus and magnesium) are highly recommended within 14 days of denosumab injection. It is important to maintain calcium levels with adequate calcium and vitamin D supplementation.
Minor:
pamidronate
Pamidronate has a minor potential interaction with Renal Dysfunction.
Pamidronate has been associated with renal toxicity manifested as deterioration of renal function, and potential renal failure. Due to this risk, single doses of pamidronate disodium should not exceed 90 mg (see manufacturers instructions for appropriate infusion durations). Patients who receive pamidronate should have serum creatinine assessed prior to each treatment. Pamidronate is primarily eliminated intact by the kidney, and the risk of renal adverse reactions may be greater in patients with renal impairment. Caution and regular monitoring (prior to each treatment) is recommended.
Thyroid Disease
Major:
Ospomyv
The denosumab in Ospomyv has a major potential interaction with Thyroid Disease.
Preexisting hypocalcemia must be corrected prior to initiating treatment with denosumab. Caution should be exercised in patients predisposed to hypocalcemia and any disturbances of mineral metabolism, such as history of hypoparathyroidism, thyroid or parathyroid surgery, malabsorption syndromes, excision of small intestine, severe renal impairment or dialysis. Clinical monitoring of calcium and mineral levels (phosphorus and magnesium) are highly recommended within 14 days of denosumab injection. It is important to maintain calcium levels with adequate calcium and vitamin D supplementation.
Moderate:
pamidronate
Pamidronate has a moderate potential interaction with Thyroid Disease.
Standard hypercalcemia- related metabolic parameters, such as serum levels of calcium, phosphate, magnesium, and potassium, should be carefully monitored following initiation of therapy with pamidronate. Cases of asymptomatic hypophosphatemia, hypokalemia, hypomagnesemia, and hypocalcemia have been reported. Additionally, some rare cases of symptomatic hypocalcemia (including tetany), have been observed. Patients with a history of thyroid surgery may have relative hypoparathyroidism that may predispose to hypocalcemia with pamidronate.
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More resources
Ospomyv
A total of 324 drugs are known to interact with Ospomyv.
- Ospomyv is in the drug class miscellaneous bone resorption inhibitors.
- Ospomyv is used to treat Osteoporosis.
pamidronate
A total of 129 drugs are known to interact with pamidronate.
- Pamidronate is in the drug class bisphosphonates.
- Pamidronate is used to treat the following conditions:
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.