Prolia interactions: Alcohol, medications, and other factors

Prolia interactions with other medications  

Before you start treatment with Prolia, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Prolia interacts with supplements, herbs, or vitamins, see the “Prolia and other interactions” section.)

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of drugs that can interact with Prolia. Keep in mind that this table doesn’t include all drugs that may interact with Prolia. Some of these interactions are described in detail in “Drug interactions in depth.”

When to avoid Prolia

In some cases, factors or conditions could prevent your doctor from prescribing Prolia due to the risk of harm. These are known as contraindications. The contraindications of Prolia include:

Having low blood calcium

Doctors typically won’t prescribe Prolia if you have low blood calcium (hypocalcemia). Prolia can cause hypocalcemia as a side effect, and this side effect can be life threatening in extreme cases. If you already have hypocalcemia, treatment with Prolia could worsen it.

As a result, your doctor will prescribe treatment for hypocalcemia before prescribing Prolia to you. Or they can recommend a different treatment for your condition besides Prolia.

Are pregnant or may become pregnant

Doctors typically won’t prescribe Prolia during pregnancy. They’re also unlikely to prescribe the drug for this use if you’re able to become pregnant and are not using effective birth control.

This is because Prolia may not be safe to take during pregnancy.

For treatment of osteoporosis or low bone mass during pregnancy, your doctor can recommend a different treatment that’s safe for use in pregnancy. If you’re able to become pregnant, your doctor can advise you on birth control options to use while taking Prolia for your condition.

Having had an allergic reaction to Prolia or any of its ingredients

If you have had an allergic reaction to Prolia or any of its ingredients, your doctor will likely not prescribe Prolia. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Note: Before you start treatment with Prolia, it’s important to tell your doctor if these contraindications apply to you. They can determine whether to prescribe Prolia.

Prolia interaction with alcohol

There aren’t any known interactions between Prolia and alcohol. However, your doctor may advise you to avoid or limit alcohol consumption during Prolia treatment.

This is because drinking alcohol may increase your risk of bone fractures, especially if you have osteoporosis or another condition causing low bone mass.

If you have questions about drinking alcohol during Prolia treatment, talk with your doctor.

Drug interactions in depth

Here’s a closer look at certain drug interactions of Prolia.

Corticosteroids

Prolia can interact with corticosteroids. Corticosteroid medications are prescribed to treat many different conditions, including skin conditions such as eczema and psoriasis, as well as inflammatory bowel disease, asthma, and multiple sclerosis (MS).

Interaction result: Taking Prolia and corticosteroids together can increase the risk of osteonecrosis of the jaw (ONJ) as a side effect of Prolia or corticosteroids.

Interaction explained: Both Prolia and corticosteroids can cause ONJ when used on their own. Taking these medications together further increases the risk of this side effect.

Examples of corticosteroid drugs: Here are some corticosteroids that may interact with Prolia:

• prednisone (Rayos)
• dexamethasone (Hemady)
• budesonide (Tarpeyo, others)
• methylprednisolone (Medrol, Depo-Medrol, Solu-Medrol)

Steps you or your doctor may take: Your doctor may decide to avoid prescribing Prolia and corticosteroids together to avoid this interaction. If your doctor prescribes Prolia and a corticosteroid together to you, they’ll likely have you watch closely for any symptoms of ONJ. You should immediately notify your doctor if you notice symptoms such as pain in your mouth, trouble chewing, and swelling in your gums or soft tissue inside your mouth.

Calcimimetics

Prolia can interact with calcimimetics, which are prescribed to treat hyperparathyroidism, including hyperparathyroidism related to chronic kidney disease.

Interaction result: Taking Prolia and a calcimimetic together can increase the risk of low blood calcium (hypocalcemia) as a side effect of Prolia or calcimimetics.

Interaction explained: Taken on their own, Prolia and calcimimetics can cause hypocalcemia as a side effect. If these medications are taken together, the risk of this side effect increases.

Examples of calcimimetics drugs: Here are some calcimimetics that may interact with Prolia:

• cinacalcet (Sensipar)
• etelcalcetide (Parsabiv)

Steps you or your doctor may take: Due to this interaction, your doctor may prefer to avoid prescribing Prolia and a calcimimetic medication together. Or, if they prescribe this combination to you, they’ll likely closely monitor your blood calcium level. They’ll also likely recommend you take a vitamin D and calcium supplement throughout treatment with Prolia.

Immunosuppressants

Prolia can interact with immunosuppressant medications. Immunosuppressants are medications that lower the activity of your immune system. Many medications are considered immunosuppressants. They have a variety of different uses, including preventing organ rejection after an organ transplant and treating conditions such as certain cancers and autoimmune conditions, such as lupus.

Interaction result: Taking Prolia and an immunosuppressant together can increase the risk of infection as a side effect of Prolia or immunosuppressants.

Interaction explained: Treatment with Prolia or an immunosuppressant on its own raises your risk of infection as a side effect. Taking these medications together further raises your risk of infection as a side effect.

Examples of immunosuppressant drugs: Here are some immunosuppressant drugs that may interact with Prolia:

• adalimumab (Humira)
• cyclosporine (Gengraf, Neoral)
• tofacitinib (Xeljanz)
• tacrolimus (Astagraf XL, Envarsus XR, Prograf)
• secukinumab (Cosentyx)

Steps you or your doctor may take: If your doctor prescribes Prolia and an immunosuppressant for you to take, they may monitor you closely for infections throughout treatment. Be sure to contact your doctor right away if you think you have symptoms of an infection, as they’ll likely want to treat it right away.

Your doctor may also decide the risks outweigh the benefits and that you should not take Prolia with an immunosuppressant. In this case, your doctor can recommend an alternative treatment besides Prolia or the immunosuppressant for your condition.

Prolia and other interactions

Prolia may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Prolia.

Prolia interactions with supplements

Before you start treatment with Prolia, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Prolia interactions with herbs

There are no specific reports of herbs interacting with Prolia. However, that doesn’t mean herbal interactions won’t occur or be recognized in the future. Because of this, it’s important to check with your doctor or pharmacist before taking any of these products during Prolia treatment.

Prolia interactions with vitamins

There are no specific reports of vitamins interacting with Prolia. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Prolia.

Prolia interactions with food

There are no reports of food interactions with Prolia. If you’d like to learn more about eating certain foods during treatment with Prolia, talk with your doctor.

Prolia interactions with vaccines

Prolia may interact with live vaccines. A live vaccine contains live but weakened pieces of the virus or bacterium it’s meant to defend against. When your immune system is healthy, live vaccines usually won’t cause infection.

But Prolia treatment may weaken your immune system. So if you get a live vaccine, your immune system may not be able to fight the virus or bacterium. This may cause you to become sick or develop symptoms of the illness the vaccine is meant to prevent.

Examples of live vaccines to avoid during Prolia treatment include:

• measles, mumps, rubella (MMR)
• chickenpox
• flu vaccine (nasal spray form)

Before starting Prolia, talk with your doctor or pharmacist about any vaccines you may need.

Prolia interactions with lab tests

Prolia may interfere with the results of the tuberculin purified protein derivative (PPD) skin test. Specifically, Prolia treatment may cause a false-negative result for this test. A false-negative for the tuberculin PPD skin test means the test shows you don’t have tuberculosis (TB) but an infection is actually present.

Due to this, your doctor may order a different test if you need a test to check for TB.

For additional information, talk with your doctor or pharmacist.

PROLIA INTERACTION WITH CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Prolia. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Prolia. The impact of cannabis may affect how well you stick to your Prolia treatment plan.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Prolia and health-related interactions

Certain medical conditions and other factors may increase the risk of interactions with Prolia. Before you take this drug, be sure to talk with your doctor about your health history. Prolia may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Prolia include:

• Advanced kidney disease: Prolia has a boxed warning about the risk of severe low blood calcium in people with advanced chronic kidney disease. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). To learn more, see the introduction of this article.
• Malabsorption syndrome or missing small intestine: If you have malabsorption syndrome or have had your small intestine surgically removed, you have a higher risk of low blood calcium (hypocalcemia) as a side effect of taking Prolia. If your doctor prescribes Prolia to you, they’ll likely closely monitor the level of calcium and other minerals (such as magnesium) in your blood during your treatment. They’ll also likely suggest you take vitamin D and calcium supplements during treatment with Prolia.
• Low parathyroid activity (hypoparathyroidism): If you have low parathyroid activity, you face a higher risk of low blood calcium as a side effect of receiving Prolia. If your doctor decides to prescribe Prolia to you, they’ll likely suggest you take vitamin D and calcium supplements during treatment with Prolia. And they’ll also monitor the level of calcium and other minerals (such as magnesium) in your blood during your treatment.
• Recent invasive dental procedures or certain dental conditions: If you’ve recently had certain dental procedures, such as tooth extraction or dental implants, you may have a higher risk of osteonecrosis of the jaw (ONJ) as a side effect of Prolia. Having certain dental conditions, such as periodontitis, can also increase your risk of ONJ as a side effect of Prolia. If you’ve recently had a dental procedure, your doctor may want you to undergo a tooth exam prior to prescribing Prolia to you. And if you begin Prolia treatment, your doctor will advise you to maintain proper oral hygiene to lower your risk of ONJ as a side effect.
• Anemia or blood clotting condition: Having anemia or a blood clotting condition (such as hemophilia) raises your risk of developing ONJ as a side effect of Prolia. Your doctor may want to ensure your anemia or blood clotting condition is properly treated before prescribing Prolia. Or they may decide to prescribe a different treatment for your condition besides Prolia.
• Allergic reaction: If you’ve had an allergic reaction to Prolia or any of its ingredients, your doctor will likely not prescribe Prolia. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
• Breastfeeding: It’s not known whether it’s safe to use Prolia while breastfeeding. There isn’t enough information to determine whether the drug passes into breast milk or what effects Prolia may have on a child who is breastfed. If you’re breastfeeding or planning to, talk with your doctor before receiving Prolia. They can talk with you about treatment options and ways to feed a child who is breastfed.
• Pregnancy: Doctors typically won’t prescribe Prolia during pregnancy. They’re also unlikely to prescribe the drug for this use if you’re able to become pregnant and are not using effective birth control. To learn more, see “When to avoid Prolia.”

FAQs about Prolia and interactions

Here are some frequently asked questions about Prolia and possible interactions.

Can you take Prolia while on antibiotics?

Yes, it’s usually safe to receive Prolia while taking antibiotics. Antibiotics and Prolia aren’t reported to interact.

Treatment with Prolia can raise your risk of infection, including infections by bacteria. In this case, your doctor may prescribe an antibiotic to treat your infection. Be sure to share your medication list with your doctor, as antibiotics can interact with other medications. There are numerous different antibiotics, and they have different interactions. But they’re not expected to interact with Prolia.

Is there an interaction between Prolia and statins?

No, it’s not thought so. There aren’t reports of interactions between Prolia and statins.

Statins are medications prescribed to lower cholesterol as well as certain health risks in certain people. Statins can interact with other medications, and these interactions can differ based on the specific statin. But Prolia isn’t expected to interact with statins.

Your doctor or pharmacist can advise you on whether other medications you take interact with statins.

Preventing interactions

You can take certain steps to help prevent interactions with Prolia. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take as well as any vaccine you’ve recently received or may receive soon.
• Create a medication listTrusted Source, which your doctor and pharmacist can help you fill out.

It’s also important to read the Prolia label and other paperworkTrusted Source that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If Prolia doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Prolia by using it exactly as your doctor prescribes.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.