Drug Interaction Report

MONITOR: Because telbivudine is primarily eliminated by renal excretion, coadministration with drugs that affect renal function may alter the plasma concentrations of telbivudine and/or the coadministered drug.

MANAGEMENT: Caution is advised if telbivudine is prescribed in combination with potentially nephrotoxic drugs (e.g., aminoglycosides; polypeptide, glycopeptide, and polymyxin antibiotics; amphotericin B; adefovir; cidofovir; tenofovir; foscarnet; cisplatin; deferasirox; gallium nitrate; lithium; mesalamine; certain immunosuppressants; intravenous bisphosphonates; intravenous pentamidine; high intravenous dosages of methotrexate; high dosages and/or chronic use of nonsteroidal anti-inflammatory agents). Renal function should be evaluated prior to and during therapy with telbivudine. Adjustment of dosing interval is required in patients with renal insufficiency (creatinine clearance below 50 mL/min) at baseline or during treatment in accordance with the manufacturer's product labeling.

ADJUST DOSING INTERVAL: Food significantly decreases the bioavailability of oral ibandronate. The manufacturer reports up to a 75% decrease in bioavailability when administered 2 hours after a standard meal.

MANAGEMENT: Oral ibandronate should be administered on an empty stomach (after an overnight fast of at least 6 hours) with a 180 to 240 mL glass of plain water and no other food or drink should be taken for at least 30 minutes after administration.