Drug General Information (ID: DDI7NWM58B)
Drug Name			Tiludronic acid		Drug Info		Iron sucrose		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Bisphosphonates				Iron Supplement
Structure

Mechanism of Tiludronic acid-Iron sucrose Interaction (Severity Level: Moderate)
Complex formation Click to Show/Hide Mechanism Graph
Drug Name		Tiludronic acid				Iron sucrose
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 Iron sucrose due to formation of complexes caused by Tiludronic acid

Recommended Action
Management		Alendronate should be administered at least 1 hour before sucroferric oxyhydroxide. No dosing recommendations are available for use with other bisphosphonates. Patients may follow the manufacturers' suggestion provided in the individual bisphosphonate label regarding use with mineral supplements and other polyvalent cation-containing products (i.e., administer sucroferric oxyhydroxide at least 30 minutes after risedronate, 1 hour after ibandronate, and at least 2 hours before or 2 hours after clodronate, etidronate, or tiludronate).

References
1	Product Information. Actonel (risedronate). Procter and Gamble Pharmaceuticals, Cincinnati, OH.
2	Product Information. Bonefos (clodronate). Rhone-Poulenc Rorer Canada Inc, Laval, QC.
3	Product Information. Boniva (ibandronate). Roche Laboratories, Nutley, NJ.