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Drug Interactions between Parsabiv and tiludronate

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

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Interactions between your drugs

Major

tiludronate etelcalcetide

Applies to: tiludronate and Parsabiv (etelcalcetide)

MONITOR CLOSELY: Concomitant use of etelcalcetide with other medicines known to lower serum calcium may increase the risk of hypocalcemia. The proposed mechanism is additive reduction in serum calcium levels. Significant decreases in serum calcium may cause paraesthesias, myalgias, muscle spasms, seizures, QT interval prolongation, and ventricular arrhythmia. Etelcalcetide given alone may lead to severe hypocalcemia requiring concomitant treatment with therapies to increase serum calcium levels.

MANAGEMENT: Close monitoring of corrected serum calcium levels is recommended if etelcalcetide is used in combination with other medications known to lower serum calcium, such as denosumab, calcitonin, foscarnet, bisphosphonates, or loop diuretics. It is recommended that the patient's corrected serum calcium level should be measured within one week of initiation or dose adjustment of etelcalcetide and monitored approximately every 4 weeks. In addition, the manufacturer product labeling should be consulted for management guidelines in the event of a reduction in corrected serum calcium levels below the lower limit of the normal range and/or symptoms of hypocalcemia. Patients should also be advised to contact their health care professional if they experience symptoms of hypocalcemia, such as numbness or tingling in the fingers, toes, or around the mouth, muscle spasms, twitches or cramps, seizures, confusion, and irregular heartbeats.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."

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Drug and food interactions

Moderate

tiludronate food

Applies to: tiludronate

ADJUST DOSING INTERVAL: Food significantly decreases the bioavailability of tiludronate. The manufacturer reports up to a 90% decrease in bioavailability when administered with or 2 hours after a standard breakfast. Clinical efficacy, however, was demonstrated when tiludronate was taken 2 hours before or after meals.

MANAGEMENT: Tiludronate should be administered with 6 to 8 ounces of plain water at least 2 hours before or 2 hours after food.

References

  1. "Product Information. Skelid (tiludronate)." Sanofi Winthrop Pharmaceuticals

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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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.

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