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zoledronic acid

Pronunciation: zole DRO nik AS sid

Brand: Reclast, Zometa

What is the most important information I should know about zoledronic acid?

Multum emt

Zoledronic acid can harm your kidneys. This effect is increased when you also use other medicines harmful to the kidneys, such as: chemotherapy, antiviral medication, pain or arthritis medicine, injected antibiotics, or medicines to treat a bowel disorder or prevent organ transplant rejection. You may need dose adjustments or special tests if you use any of these medications.

Multum donot

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).

Multum nopreg

Do not use zoledronic acid if you are pregnant. It could harm the unborn baby.

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.

Multum donot

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 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 purposes not listed in this medication guide.

What should I discuss with my healthcare provider before receiving zoledronic acid?

Multum donot

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:

  • low levels of calcium in your blood; or
  • if you are pregnant or breast-feeding.

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.

Multum donot

Do not use Reclast if you have severe kidney disease.

To make sure you can safely use zoledronic acid, tell your doctor if you have any of these other conditions:

  • 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;
  • kidney disease; or
  • if you are dehydrated.

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.

Multum nopreg

FDA pregnancy category D. Do not use zoledronic acid if you are pregnant. It could harm the unborn baby. Use effective birth control, and tell your doctor if you become pregnant during treatment.

Multum nobrfeed

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.

Serious side effects on the kidneys may be more likely in older adults using zoledronic acid.

How is zoledronic acid given?

Zoledronic acid is injected into a vein through an IV. You will receive this injection in a clinic or hospital setting. Zoledronic acid must be given slowly, and the IV infusion can take at least 15 minutes to complete.

Zoledronic acid is sometimes given only once per year. Follow your doctor's instructions.

Multum water

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 medicine is helping your condition and is not causing harmful effects, your blood will need to be tested often. Your kidney function may also need to be tested. You may not need to use zoledronic acid for longer than 3 to 5 years if you use it for osteoporosis. Visit your doctor regularly.

What happens if I miss a dose?

Call your doctor for instructions if you miss an appointment for your zoledronic acid injection.

What happens if I overdose?

Multum emt

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include numbness or tingling in your hands and feet, muscle stiffness, spasms in the muscles of your face, uneven heartbeats, and wheezing or trouble breathing.

What should I avoid while receiving zoledronic acid?

Multum donot

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 are the possible side effects of zoledronic acid?

Multum emt

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.

Multum donot

Call your doctor at once if you have a serious side effect such as:

  • urinating less than usual or not at all;
  • drowsiness, confusion, mood changes, increased thirst, loss of appetite, nausea and vomiting;
  • swelling, weight gain, feeling short of breath;
  • muscle spasms, numb or tingly feeling (especially around your mouth);
  • fever, chills, body aches, flu symptoms;
  • pale skin, easy bruising, unusual weakness;
  • feeling like you might pass out;
  • severe joint, bone, or muscle pain;
  • new or unusual pain in your thigh or hip; or
  • bronchospasm (wheezing, chest tightness, trouble breathing).

Less serious side effects may include:

  • cough;
  • vision problems;
  • 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 other drugs will affect zoledronic acid?

Multum emt

Zoledronic acid can harm your kidneys. This effect is increased when you also use other medicines harmful to the kidneys. You may need dose adjustments or special tests if you have recently used:

  • a diuretic (water pill);
  • lithium (Eskalith, Lithobid);
  • methotrexate (Rheumatrex, Trexall);
  • pain or arthritis medicines such as aspirin (Anacin, Excedrin), acetaminophen (Tylenol), ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Arthrotec, Cambia, Cataflam, Voltaren, Flector Patch, Pennsaid, Solareze), indomethacin (Indocin), meloxicam (Mobic), and others;
  • medicines used to treat ulcerative colitis, such as mesalamine (Pentasa) or sulfasalazine (Azulfidine);
  • medicine used to prevent organ transplant rejection, such as cyclosporine (Gengraf, Neoral, Sandimmune), sirolimus (Rapamune) or tacrolimus (Prograf);
  • IV antibiotics such as amphotericin B (Amphotec, AmBisome, Abelcet), amikacin (Amikin), bacitracin (Baci IM), capreomycin (Capastat), gentamicin (Garamycin), kanamycin (Kantrex), streptomycin, or vancomycin (Vancocin, Vancoled);
  • antiviral medicines such as adefovir (Hepsera), cidofovir (Vistide), or foscarnet (Foscavir); or
  • cancer medicine such as aldesleukin (Proleukin), carmustine (BiCNU, Gliadel), cisplatin (Platinol), ifosfamide (Ifex), oxaliplatin (Eloxatin), streptozocin (Zanosar), or tretinoin (Vesanoid).

This list is not complete and other drugs may interact with zoledronic acid. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

Your doctor or pharmacist can provide more information about zoledronic acid.


Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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