What is Zoledronic Acid
Zoledronic acid (also known as zoledronate) is an intravenous (IV), heterocyclic, nitrogen-containing bisphosphonate; it is considered a third-generation bisphosphonate. Zoledronic acid is a potent inhibitor of bone resorption, making it useful in a variety of skeletal-related conditions, including hypercalcemia of malignancy, multiple myeloma, bone metastases due to solid tumors, Paget’s disease, and the treatment and prevention of osteoporosis.
Brand Names
- Reclast
- Zometa
Indications
- bone metastases
- breast cancer
- hypercalcemia
- multiple myeloma
- osteoporosis
- osteoporosis prophylaxis
- Paget’s disease
For the treatment of hypercalcemia of malignancy (i.e., albumin-corrected serum calcium 12 mg/dL or higher)
Side Effects
- abdominal pain
- agitation
- alopecia
- anaphylactoid reactions
- anemia
- angioedema
- anorexia
- anxiety
- arrhythmia exacerbation
- arthralgia
- asthenia
- atrial fibrillation
- azotemia
- back pain
- blurred vision
- bone fractures
- bone pain
- bradycardia
- bronchospasm
- chest pain (unspecified)
- chills
- confusion
- conjunctivitis
- constipation
- cough
- dehydration
- depression
- diarrhea
- dizziness
- dysgeusia
- dyspepsia
- dysphagia
- dyspnea
- erythema
- Fanconi syndrome
- fatigue
- fever
- flank pain
- flushing
- headache
- hematuria
- hyperesthesia
- hyperhidrosis
- hyperkalemia
- hypermagnesemia
- hypernatremia
- hypertension
- hyperthermia
- hypocalcemia
- hypoesthesia
- hypokalemia
- hypomagnesemia
- hypophosphatemia
- hypotension
- infection
- infertility
- influenza
- injection site reaction
- insomnia
- iritis
- lethargy
- malaise
- muscle cramps
- musculoskeletal pain
- myalgia
- nausea
- neutropenia
- ocular inflammation
- ocular pain
- osteonecrosis
- palpitations
- pancytopenia
- paresthesias
- peripheral edema
- pharyngitis
- proteinuria
- pruritus
- rash
- renal failure (unspecified)
- renal tubular necrosis
- seizures
- Stevens-Johnson syndrome
- stomatitis
- teratogenesis
- tetany
- thrombocytopenia
- toxic epidermal necrolysis
- tremor
- urticaria
- uveitis
- vertigo
- vomiting
- weight gain
- weight loss
- xerostomia
Monitoring Parameters
- CBC with differential
- serum 25(OH)hydroxyvitamin D concentrations
- serum alkaline phosphatase
- serum calcium
- serum creatinine/BUN
- serum electrolytes
- serum magnesium
- serum phosphate
Contraindications
- anemia
- asthma
- breast-feeding
- cardiac arrhythmias
- chemotherapy
- children
- coagulopathy
- contraception requirements
- corticosteroid therapy
- dehydration
- dental disease
- dental work
- diabetes mellitus
- diarrhea
- electrolyte imbalance
- ensure correct formulation selection
- fever
- geriatric
- history of angioedema
- hypertension
- hypocalcemia
- hypomagnesemia
- hypophosphatemia
- hypovolemia
- infants
- infection
- infertility
- multiple myeloma
- phosphonate hypersensitivity
- pregnancy
- pregnancy testing
- renal disease
- renal failure
- renal impairment
- reproductive risk
- seizures
- vomiting
Interactions
- Acetaminophen; Aspirin, ASA; Caffeine
- Aluminum Hydroxide
- Aluminum Hydroxide; Magnesium Carbonate
- Aluminum Hydroxide; Magnesium Hydroxide
- Aluminum Hydroxide; Magnesium Hydroxide; Simethicone
- Aluminum Hydroxide; Magnesium Trisilicate
- Amikacin
- Aminoglycosides
- Amlodipine; Celecoxib
- Aprotinin
- Aspirin, ASA
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Caffeine; Orphenadrine
- Aspirin, ASA; Carisoprodol
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Citric Acid; Sodium Bicarbonate
- Aspirin, ASA; Dipyridamole
- Aspirin, ASA; Omeprazole
- Aspirin, ASA; Oxycodone
- Aspirin, ASA; Pravastatin
- Bumetanide
- Calcium
- Calcium Acetate
- Calcium Carbonate
- Calcium Carbonate; Magnesium Hydroxide
- Calcium Carbonate; Risedronate
- Calcium Carbonate; Simethicone
- Calcium Chloride
- Calcium Gluconate
- Calcium; Vitamin D
- Capreomycin
- Celecoxib
- Chromium
- Cidofovir
- Colistimethate, Colistin, Polymyxin E
- Cyclosporine
- Diclofenac
- Diclofenac; Misoprostol
- Diflunisal
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Doravirine; Lamivudine; Tenofovir disoproxil fumarate
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
- Emtricitabine; Tenofovir disoproxil fumarate
- Entecavir
- Esomeprazole; Naproxen
- Ethacrynic Acid
- Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
- Ethinyl Estradiol; Norethindrone; Ferrous fumarate
- Etodolac
- Famotidine; Ibuprofen
- Fenoprofen
- Flurbiprofen
- Furosemide
- Gallium Ga 68 Dotatate
- Gentamicin
- Hetastarch; Dextrose; Electrolytes
- Hyaluronidase, Recombinant; Immune Globulin
- Hydrocodone; Ibuprofen
- Ibuprofen
- Ibuprofen; Oxycodone
- Ibuprofen; Pseudoephedrine
- Immune Globulin IV, IVIG, IGIV
- Indomethacin
- Inotersen
- Iohexol
- Iopamidol
- Iopromide
- Ioversol
- Iron
- Iron Salts
- Isosulfan Blue
- Kanamycin
- Ketoprofen
- Ketorolac
- Lamivudine; Tenofovir Disoproxil Fumarate
- Lansoprazole; Naproxen
- Lanthanum Carbonate
- Loop diuretics
- Mannitol
- Meclofenamate Sodium
- Mefenamic Acid
- Meloxicam
- Nabumetone
- Naproxen
- Naproxen; Pseudoephedrine
- Naproxen; Sumatriptan
- Non-Ionic Contrast Media
- Nonsteroidal antiinflammatory drugs
- Omeprazole; Sodium Bicarbonate
- Oxaprozin
- Paromomycin
- Piroxicam
- Plazomicin
- Polymyxin B
- Polymyxins
- Polysaccharide-Iron Complex
- Rofecoxib
- Sodium Bicarbonate
- Sodium Ferric Gluconate Complex; ferric pyrophosphate citrate
- Streptomycin
- Sulindac
- Tacrolimus
- Telavancin
- Telbivudine
- Tenofovir Alafenamide
- Tenofovir, PMPA
- Thalidomide
- Tobramycin
- Tolmetin
- Torsemide
- Valdecoxib
- Vancomycin
