Kitabis Pak inhalation and Risedronate Delayed-Release Tablets
Determining the interaction of Kitabis Pak inhalation and Risedronate Delayed-Release Tablets and the possibility of their joint administration.
In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.
Consumer:Using risedronate 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.
Professional:MONITOR: Coadministration of bisphosphonates and aminoglycosides may potentiate the risks of hypocalcemia and nephrotoxicity, particularly when the bisphosphonate is administered intravenously. Bisphosphonates alone often cause mild, asymptomatic hypocalcemia via inhibitive effects on bone resorption and possibly chelation of blood calcium, while aminoglycosides can induce renal tubular damage resulting in renal loss of calcium and magnesium. Hypomagnesemia, in turn, may also lead to peripheral parathyroid hormone resistance and impaired parathyroid hormone secretion, thus compromising the normal homeostatic response to hypocalcemia. The interaction has been reported in a 62-year-old patient with multiple myeloma who developed persistent, severe hypocalcemia and hypomagnesemia after treatment with oral clodronate and netilmicin. The electrolyte abnormalities were accompanied by increased serum creatinine concentration and grand mal seizures. Administration of bisphosphonates, especially by rapid IV injection, has also been associated with nephrotoxicity manifested as deterioration of renal function and renal failure.
MANAGEMENT: Caution is advised if bisphosphonates are used in patients who have recently received or are receiving treatment with aminoglycosides. Renal function as well as serum calcium and magnesium levels should be monitored during and after treatment, since renal loss of calcium and magnesium can continue for many weeks after cessation of aminoglycosides, as can the effect of bisphosphonates. Patients and clinicians should be alert to signs and symptoms of clinical hypocalcemia such as muscle spasms, carpopedal spasm, laryngeal spasm, tetany, convulsions, mental changes (irritability, depression, psychosis), increased intracranial pressure, papilledema, QT interval prolongation, and cardiac arrhythmias. For IV bisphosphonates, product labelings for pamidronate and zoledronic acid recommend that single doses not exceed 90 mg and 4 mg, respectively, and duration of infusion not less than 2 hours and 15 minutes, respectively.
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- Janssen Van Doorn K, Neyns B, Van Der Niepen P, Verbeelen D "Pamidronate-related nephrotoxicity (tubulointerstitial nephritis) in a patient with osteolytic bone metastases." Nephron 89 (2001): 467-8
- Markowitz GS, Fine PL, Stack JI, et al. "Toxic acute tubular necrosis following treatment with zoledronate (Zometa)." Kidney Int 64 (2003): 281-289
- "Product Information. Zometa (zoledronic acid)." Novartis Pharmaceuticals, East Hanover, NJ.
- "Product Information. Ostac (clodronate)." Hoffmann-La Roche Limited, Mississauga, IA.
- Lockridge L, Papac RJ, Perazella MA "Pamidronate-associated nephrotoxicity in a patient with Langerhans's histiocytosis." Am J Kidney Dis 40 (2002): E2
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- Pedersen-Bjergaard U, Myhre J "Severe hypocalcaemia [corrected] after treatment with diphosphonate and aminoglycoside." Br Med J 302 (1991): 295
- Zazgornik J, Grafinger P, Biesenbach G, Hubmann R, Fridrik M "Acute renal failure and alendronate." Nephrol Dial Transplant 12 (1997): 2797-8
- Banerjee D, Asif A, Striker L, Preston RA, Bourgoignie JJ, Roth D "Short-term, high-dose pamidronate-induced acute tubular necrosis: The postulated mechanisms of bisphosphonate nephrotoxicity." Am J Kidney Dis 41 (2003): E18
Generic Name: tobramycin
Brand name: Bethkis, Kitabis Pak, Tobi, TOBI Podhaler
Synonyms: Kitabis Pak (inhalation), Kitabis Pak
Generic Name: risedronate
Brand name: Actonel, Atelvia
Synonyms: Risedronate
In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.
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