Drug General Information (ID: DDIBDSO1H6)
Drug Name			Zoledronic acid		Drug Info		Sunitinib		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Bone Density Conservation Agents				Antineoplastics
Structure

Mechanism of Zoledronic acid-Sunitinib Interaction (Severity Level: Moderate)
Increased risk of other adverse reactions (Unspecific) Click to Show/Hide Mechanism Graph
Drug Name		Zoledronic acid				Sunitinib
Mechanism		Risk of osteonecrosis of the jaw				Risk of osteonecrosis of the jaw
Key Mechanism Factor 1
		Factor Name		Adverse reactions
		Factor Description		An adverse reaction is an unexpected negative reaction to a medication or treatment that happens even when it's used correctly.
Mechanism Description		Increased risk of adverse reactions by the combination of Zoledronic acid and Sunitinib

Recommended Action
Management		Caution is advised if bisphosphonates are used simultaneously or sequentially with denosumab or bevacizumab. Prior to initiating treatment, a thorough dental examination and appropriate preventive dentistry should be considered. If possible, invasive dental procedures should be avoided in patients who have previously received or are receiving intravenous bisphosphonates. Good oral hygiene practices should be maintained during treatment. Patients should be advised to seek medical attention if they experience signs and symptoms of osteonecrosis in the jaw, such as: pain in the mouth, teeth, or jaw, swelling or sores inside the mouth, numbness or a feeling of heaviness in the jaw, loosening of a tooth, or exposure of bone in the jaw. Temporary interruption of treatment should be considered if clinically appropriate, until the condition resolves.

References
1	Cerner Multum, Inc. "Australian Product Information.".
2	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
3	Product Information. Sutent (sunitinib). Pfizer U.S. Pharmaceuticals Group, New York, NY.