Drug General Information (ID: DDI4RSTD1V)
Drug Name			Tiludronic acid		Drug Info		Tetraferric tricitrate decahydrate		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Bisphosphonates				Phosphate Binders
Structure

Mechanism of Tiludronic acid-Tetraferric tricitrate decahydrate Interaction (Severity Level: Moderate)
Complex formation Click to Show/Hide Mechanism Graph
Drug Name		Tiludronic acid				Tetraferric tricitrate decahydrate
Mechanism		Binds to polyvalent cations				Polyvalent cations
Key Mechanism Factor 1
		Factor Name		Chelation
		Factor Description		Chelation is a direct drug interaction that usually involves the formation of dimers or trimers, resulting in larger complexes and poorer absorption.
Mechanism Description		Decreased absorption of Tetraferric tricitrate decahydrate due to formation of complexes caused by Tiludronic acid

Recommended Action
Management		Antacids or other oral medications containing aluminum, calcium, magnesium and other polyvalent cations should be administered at least 2 hours before or 2 hours after the bisphosphonate dose.

References
1	Product Information. Boniva (ibandronate). Roche Laboratories, Nutley, NJ.
2	Product Information. Fosamax (alendronate). Merck &amp Co, Inc, West Point, PA.
3	Product Information. Skelid (tilundronate). Sanofi Winthrop Pharmaceuticals, New York, NY.