Severe hypocalcaemia occurred in three patients given sodium clodronate when they were also given netilmicin or amikacin.
If bisphosphonates are given with aminoglycosides, caution and close monitoring of calcium and magnesium levels has been advised. The renal loss of calcium and magnesium can continue for weeks after aminoglycosides are stopped, and bisphosphonates can also persist in bone for weeks. This means that the interaction is potentially possible whether the drugs are given concurrently or sequentially.
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