Oral Bisphosphonates/Oral Multivalent Cations Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

When these two medicines are taken together, they may bind to each other in your stomach. This prevents your body from absorbing your bisphosphonate.

What might happen:

The blood levels of your bisphosphonate may be decreased and it may not work as well.

What you should do about this interaction:

You should time when you take your bisphosphonate and products containing aluminum, magnesium, iron, or zinc so that you do not these products:- until at least 30 minutes after taking alendronate- within 2 hours of etidronate- until at least 1 hour after taking ibandronate- until at least 30 minutes after takings risedronate- within 2 hours of tiludronateIf you are not sure which bisphosphonate you are on or if you have questions about the timing of doses of your medicine, contact your healthcare professionals (e.g. doctor or pharmacist). They may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

  • 1.Fosamax (alendronate sodium) US prescribing information. Merck & Co., Inc. August, 2019.
  • 2.Didronel (etidronate disodium) US prescribing information. Warner Chilcott (US), LLC April, 2015.
  • 3.Boniva (ibandronate sodium) tablets US prescribing information. Roche Therapeutics, Inc. January, 2022.
  • 4.Actonel (risedronate sodium) US prescribing information. Warner Chilcott (US), LLC April, 2015.
  • 5.Skelid (tiludronate disodium) US prescribing information. Sanofi-Aventis U.S. LLC March, 2010.
  • 6.Loron (disodium clodronate) UK summary of product characteristics. Roche Products Limited October 25, 2006.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.