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Precautions and Warnings With Tiludronate

Talking to your healthcare provider about the precautions and warnings with tiludronate before starting treatment can help reduce risks. Before taking the drug, let your healthcare provider know if you have kidney disease or any allergies. Tiludronate may not be recommended for people with severe kidney disease. You should not take tiludronate if you are allergic to any active or inactive components of the medicine.

Tiludronate: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking tiludronate disodium (Skelid®) if you have:
  • Kidney disease, including kidney failure (renal failure)
  • Any allergies, including allergies to food, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding
  • Planning to have a dental procedure.
Make sure to tell your healthcare provider about all other medicines you may be taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Specific Warnings and Precautions for Tiludronate

Warnings and precautions to be aware of prior to taking tiludronate include the following:
  • In rare cases, bisphosphonates (including tiludronate) have caused a condition called osteonecrosis of the jaw. This is a serious, possibly disfiguring problem in which the bone of the jaw dies. Often, there are symptoms (such as pain, infection, or loosening of the teeth), but sometimes there are no symptoms until a person notices exposed bone.

This problem is most common when bisphosphonates are given by IV (but is still possible when these medications are taken orally). It seems that people who have dental procedures (such as a tooth extraction) are also at higher risk. Be sure to take good care of your mouth and teeth by seeing your dentist frequently. Let your healthcare provider know right away if you think you may have osteonecrosis of the jaw.  

  • It is important to get enough calcium and vitamin D (either through your diet or by supplementation). Calcium and vitamin D are necessary for rebuilding bone and preventing further bone loss. Tiludronate cannot work if you do not get enough calcium and vitamin D.
  • Tiludronate may not be recommended for people with severe kidney disease.
  • Bisphosphonates (including tiludronate) can cause extreme muscle or bone pain. This usually goes away once the medication is stopped.
  • Tiludronate (like all bisphosphonates) can irritate the esophagus and stomach, possibly causing esophageal or stomach ulcers. Let your healthcare provider know if you develop throat pain, chest pain, or difficulty swallowing (which may be signs of ulcers of the esophagus) or severe heartburn or heartburn that does not go away (which may be signs of a stomach ulcer).
  • Tiludronate can potentially interact with a number of medications (see Drug Interactions With Tiludronate).
  • Tiludronate is considered a pregnancy Category C medication. This means that it may not be safe for use during pregnancy (see Skelid and Pregnancy).
  • It is not known whether tiludronate passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Skelid and Breastfeeding).
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