What is zoledronic acid?
Zoledronic acid (sometimes called zoledronate) is in a group of medicines called
bisphosphonates (bis FOS fo nayts). Zoledronic acid inhibits the release of calcium from bones.
Zoledronic acid is used to treat Paget's disease, and high blood levels of calcium caused by
cancer (hypercalcemia of malignancy). Zoledronic acid also treats multiple myeloma (a type of bone
marrow cancer) or bone cancer that has spread from elsewhere in the body.
Zoledronic acid is also used to treat or prevent osteoporosis in postmenopausal women, and to
increase bone mass in men with osteoporosis. Zoledronic acid is used to treat or prevent osteoporosis
in people who will be taking certain steroid medicines for 12 months or longer.
Zoledronic acid may also be used for other purposes not listed in this medication guide.
What should I discuss with my healthcare provider before taking zoledronic acid?
You should not receive this medication if you are allergic to zoledronic acid or similar
medicine such as alendronate (Fosamax), etidronate (Didronel), ibandronate (Boniva), pamidronate
(Aredia), risedronate (Actonel), or tiludronate (Skelid).
You should also not receive zoledronic acid if you have:
Zometa and Reclast are two different brands of zoledronic acid. You should
not be treated with Reclast if you are already receiving Zometa. Before receiving a Reclast injection,
tell your doctor if you are already being treated with Zometa.
Before receiving zoledronic acid, tell your doctor if you have:
-
aspirin-sensitive asthma;
-
a thyroid or parathyroid disorder;
-
malabsorption syndrome (an inability to absorb food and
nutrients properly);
-
a history of surgical removal of part of your intestine;
-
bone cancer; or
-
kidney disease.
Your doctor may recommend you have a dental exam for preventive tooth
and gum care before you start your treatment with zoledronic acid. This is especially important if you
have cancer, if you are undergoing chemotherapy or using steroids, or if you have poor dental health.
Some people using medicines similar to zoledronic acid have developed bone loss in the jaw,
also called osteonecrosis of the jaw. Symptoms of this condition may include jaw pain, swelling,
numbness, loose teeth, gum infection, or slow healing after injury or surgery involving the gums.
You may be more likely to develop osteonecrosis of the jaw if you have cancer or have been
treated with chemotherapy, radiation, or steroids. Other conditions associated with osteonecrosis of
the jaw include blood clotting disorders, anemia (low red blood cells), and dental surgery or
pre-existing dental problems.
FDA pregnancy category D. This medication can cause harm to an unborn baby. Do not
receive zoledronic acid without telling your doctor if you are pregnant. Use an effective form of birth
control, and tell your doctor if you become pregnant during treatment.
Zoledronic acid can pass into breast milk and may harm a nursing baby. Do not receive
this medication without telling your doctor if you are breast-feeding a baby.
How should I take zoledronic acid?
Zoledronic acid is given as an injection through a needle placed into a vein. You will receive
this injection in a clinic or hospital setting. The medicine must be given slowly through an IV infusion,
and can take at least 15 minutes to complete.
Zoledronic acid is sometimes given only once per year. Follow your doctor's instructions.
Drink at least 2 glasses of water within a few hours before your injection to keep from
getting dehydrated.
Your doctor may want you to take a calcium and/or vitamin D supplement while you are being
treated with zoledronic acid. Carefully follow your doctor's instructions about the type and strength of
calcium to take.
To be sure this medication is helping your condition and not causing harmful side effects, your
blood will need to be tested on a regular basis. Your kidney function may also need to be tested. It is
important that you not miss any scheduled visits to your doctor.
What happens if I miss a dose of zoledronic acid?
Contact your doctor if you miss a dose of zoledronic acid.
Where can I get more information about zoledronic acid?
Your pharmacist has information about zoledronic acid written for health professionals that you may read.
What are the possible side effects of zoledronic acid?
Get emergency medical help if you have any of these
signs of an allergic
reaction:
hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have any of these serious side effects:
-
urinating less than usual or not at all;
-
muscle spasms, numb or tingly feeling (especially around
your mouth);
-
fever, chills, body aches, flu symptoms;
-
pale skin, easy bruising, unusual weakness;
-
severe joint, bone, or muscle pain; or
-
bronchospasm (wheezing, chest tightness, trouble
breathing).
Less serious side effects may include:
-
cough;
-
loss of appetite, nausea, vomiting;
-
diarrhea, constipation;
-
headache, tired feeling;
-
mild joint or muscle pain; or
-
redness or swelling where the needle was placed.
This is not a complete list of side effects and others may occur. Call your
doctor for medical advice about side effects. You may report side effects to FDA at
1-800-FDA-1088.
What is the most important information I should know about zoledronic acid?
Do not receive zoledronic acid without telling your doctor if you have had an allergic
reaction to zoledronic acid or similar medicine such as alendronate (Fosamax), etidronate (Didronel),
ibandronate (Boniva), pamidronate (Aredia), risedronate (Actonel), or tiludronate (Skelid).
Do not
use this medication without telling your doctor if you are pregnant.
It could cause harm to the unborn baby. Use an effective form of birth control, and tell your doctor if
you become pregnant during treatment.
Your doctor may recommend you have a dental exam for preventive tooth and gum care before
you start your treatment with zoledronic acid. This is especially important if you have cancer, if you are
undergoing chemotherapy or using steroids, or if you have poor dental health.
Some people using medicines similar to zoledronic acid have developed bone loss in the jaw,
also called osteonecrosis of the jaw. Symptoms of this condition may include jaw pain, swelling,
numbness, loose teeth, gum infection, or slow healing after injury or surgery involving the gums. You
may be more likely to develop osteonecrosis of the jaw if you have cancer or have been treated with
chemotherapy, radiation, or steroids. Other conditions associated with osteonecrosis of the jaw include
blood clotting disorders, anemia (low red blood cells), and pre-existing dental problems.
Avoid having any type of dental surgery while you are being treated with zoledronic acid. It
may take longer than normal for you to recover.
What should I avoid while taking zoledronic acid?
Avoid having any type of dental surgery while you are being treated with zoledronic acid. It
may take longer than normal for you to recover.
What other drugs will affect zoledronic acid?
Before receiving zoledronic acid, tell your doctor if you are using any of the following drugs:
-
a diuretic (water pill);
-
an antibiotic such as amikacin (Amikin), gentamicin
(Garamycin), kanamycin (Kantrex), neomycin (Mycifradin, Neo-Fradin, Neo-Tab), streptomycin,
tobramycin (Nebcin, Tobi);
-
other medicines that can harm your kidneys, such as
pentamidine (Nebupent), tacrolimus (Prograf), amphotericin B (Fungizone, AmBisome,
Amphotec, Abelcet), capreomycin (Capastat), rifampin (Rifadin, Rimactane, Rifater),
vancomycin (Vancocin, Vancoled), acyclovir (Zovirax), adefovir (Hepsera), cidofovir (Vistide),
or foscarnet (Foscavir);
-
cancer medicine such as aldesleukin (Proleukin),
carmustine (BiCNU, Gliadel), cisplatin (Platinol), ifosfamide (Ifex), oxaliplatin (Eloxatin),
streptozocin (Zanosar), thalidomide (Thalomid), or tretinoin (Vesanoid); or
-
a non-steroidal anti-inflammatory drug (NSAID) such as
ibuprofen (Motrin, Advil), naproxen (Aleve, Naprosyn), diclofenac (Cataflam, Voltaren),
etodolac (Lodine), indomethacin (Indocin), ketoprofen (Orudis), piroxicam (Feldene), and
others.
This list is not complete and there may be other drugs that can interact with
zoledronic acid. Tell your doctor about all the prescription and over-the-counter medications you use.
This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start
using a new medication without telling your doctor.
What happens if I have an overdose of zoledronic acid?
