Drug General Information (ID: DDI58C2WVI)
Drug Name			Calcium acetate		Drug Info		Tiludronic acid		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Phosphate Binders				Bisphosphonates
Structure

Mechanism of Calcium acetate-Tiludronic acid Interaction (Severity Level: Moderate)
Complex formation Click to Show/Hide Mechanism Graph
Drug Name		Calcium acetate				Tiludronic acid
Mechanism		Polyvalent cations				Binds to 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 Calcium acetate 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.