Drug General Information (ID: DDIC8TWHQG)
Drug Name			Ibandronate		Drug Info		Romosozumab		Drug Info
Drug Type		Small molecule				Monoclonal antibody
Therapeutic Class		Bone Density Conservation Agents				Bone Resorption Inhibitors

Mechanism of Ibandronate-Romosozumab Interaction (Severity Level: Moderate)
Increased risk of other adverse reactions (Unspecific) Click to Show/Hide Mechanism Graph
Drug Name		Ibandronate				Romosozumab
Mechanism		Increase the risk of osteonecrosis of the jaw combined with romosozumab				Romosozumab
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 Ibandronate and Romosozumab

Recommended Action
Management		Caution is advised when romosozumab is used with other agents that are also associated with osteonecrosis of the jaw. A routine oral examination should be performed by the prescriber prior to initiation of romosozumab treatment. For patients requiring invasive dental procedures, clinical judgment and risk-benefit assessment should guide the management plan of each patient based on their clinical circumstances. Patients should be advised to seek medical attention if they experience signs and symptoms of ONJ, 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.

References
1	Product Information. Evenity (romosozumab). Amgen USA, Thousand Oaks, CA.