Drug Interaction Report

Using tiludronate together with tobramycin can cause damage to the kidneys and hypocalcemia (low blood calcium). Symptoms of kidney damage include swelling, weight gain, feeling short of breath, drowsiness, confusion, mood changes, increased thirst, loss of appetite, nausea and vomiting, pain in your lower back, and urinating more or less than usual or not at all. Symptoms of hypocalcemia include muscle spasms, convulsions, mental changes (irritability, depression, psychosis), increased pressure on the brain, and an irregular heartbeat. If you take both medications together, tell your doctor if you have any of these symptoms. You may need a dose adjustment or special tests to safely use these medications together. 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.

Food significantly decreases the levels of tiludronate. Tiludronate should be administered on an empty stomach with 6 to 8 ounces of plain water at least 2 hours before or 2 hours after food. This will make it easier for your body to absorb the medication.