Drug Interaction Report

MONITOR: Administration of technetium (Tc 99m) oxidronate after chelating agents, diphosphonates, tetracyclines, or iron containing drugs may reduce the quality of the scintigraphic procedure by decreasing the accumulation of Tc 99m oxidronate in skeletal bone. The exact mechanism of the interaction is unknown; however, it may be related to the effects of the interacting drugs on bone homeostasis.

MANAGEMENT: Proceed with caution if chelating agents, diphosphonates, tetracyclines, and iron-containing drugs are used prior to technetium (Tc 99m) oxidronate. The quality of the resulting imaging may be reduced.

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.