zoledronic acid

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Pronunciation: ZOE le DRON ik AS id

Brand: Reclast, Zometa

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

Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

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.

Zometa and Reclast are two different brands of zoledronic acid.

The Reclast brand of zoledronic acid is used to treat Paget's disease, and to treat or prevent osteoporosis in postmenopausal women or people who take certain steroid medicines. Reclast is also used to increase bone mass in men with osteoporosis.

The Zometa brand of zoledronic acid is used to treat high blood levels of calcium caused by cancer (hypercalcemia of malignancy). Zometa also treats multiple myeloma (a type of bone marrow cancer) or bone cancer that has spread from elsewhere in the body.

You should not be treated with Reclast if you are already receiving Zometa.

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?

You should not use zoledronic acid if you are allergic to it.

You also should not use Reclast if you have:

  • severe kidney disease; or
  • low levels of calcium in your blood.

To make sure zoledronic acid is safe for you, tell your doctor if you have:

  • kidney disease;
  • a history of thyroid or parathyroid surgery;
  • malabsorption syndrome (an inability to absorb food and nutrients properly);
  • a history of surgical removal of part of your intestine;
  • asthma caused by taking aspirin;
  • planned dental work or oral surgery;
  • if you are dehydrated;
  • if you take a diuretic ("water pill"); or
  • if you are using other bisphosphonates (alendronate, etidronate, ibandronate, pamidronate, risedronate, Actonel, Fosamax, Boniva, and others).

In rare cases, this medicine may cause bone loss (osteonecrosis) in the jaw. Symptoms include jaw pain or numbness, red or swollen gums, loose teeth, or slow healing after dental work. The longer you use zoledronic acid, the more likely you are to develop this condition.

Osteonecrosis of the jaw may be more likely if you have cancer or received chemotherapy, radiation, or steroids. Other risk factors include blood clotting disorders, anemia (low red blood cells), and a pre-existing dental problem.

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.

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.

Zoledronic acid can pass into breast milk and may harm a nursing baby. You should not breast-feed while using this medicine.

How is zoledronic acid given?

Zoledronic acid is injected into a vein through an IV. A healthcare provider will give you this injection.

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.

You may need frequent medical tests to help your doctor determine how long to treat you with zoledronic acid. Your kidney function may also need to be checked.

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?

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

What should I avoid while receiving 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 are the possible side effects of zoledronic acid?

Get emergency medical help if you have signs of an allergic reaction: hives; wheezing, chest tightness, trouble breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • fever, chills, flu symptoms, flushing (warmth, redness, or tingly feeling);
  • severe joint, bone, or muscle pain;
  • new or unusual pain in your hip, thigh or groin;
  • a loose tooth, mouth pain, mouth sores;
  • pale skin, feeling light-headed or short of breath;
  • hypocalcemia --numbness or tingly feeling in your fingers or toes or around your mouth, twitching, muscle spasms or cramps;
  • signs of a kidney problem --little or no urinating; painful or difficult urination; swelling, rapid weight gain; feeling tired or short of breath; or
  • severe skin reaction --fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

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

Common side effects may include:

  • nausea, vomiting, diarrhea, constipation;
  • bone pain, muscle or joint pain;
  • fever or other flu symptoms;
  • pain in your arms or legs;
  • headache, tiredness; or
  • trouble breathing.

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?

Zoledronic acid can harm your kidneys. This effect is increased when you also use certain other medicines, including: antivirals, chemotherapy, injected antibiotics, medicine for bowel disorders, medicine to prevent organ transplant rejection, injectable osteoporosis medication, and some pain or arthritis medicines (including aspirin, Tylenol, Advil, and Aleve).

Other drugs may interact with zoledronic acid, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

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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