Zoledronic Acid
Description
Zoledronic Acid is used to treat bone loss and decrease the risk of fractures i
n certain groups of patients. It belongs to a class of medicines called ‘Bisphosphonates.’
Uses of Zoledronic Acid
- Treatment of thinning of bone or bone loss (osteoporosis) in adult men and postmenopausal women (age-related termination of menstrual periods)
- In patients who are at increased risk for fracture or had a recent hip fracture. This includes patients being treated with or without glucocorticoids (a class of medicines that suppress the immune response, e.g. Methylprednisolone, Dexamethasone, etc.)...
- Treatment of Paget’s disease of the bone in adults (a bone disorder more common in white adults, in which the bone becomes weakened and bent)
Contraindications of Zoledronic Acid
When should one not use Zoledronic Acid
- Hypersensitivity to Zoledronic Acid or any of the components of the medicine or other Bisphosphonates
- Severe kidney diseases
- Low blood calcium levels (hypocalcemia)
Side effects of Zoledronic Acid
Common side effects of this drug are:
- Abnormal heart rhythms (common, but inform the doctor promptly), especially seen in postmenopausal women
- Increased sensitivity to light, swollen, red and painful eyes with itching (uncommon)
- A serious condition called osteonecrosis of the jaw can occur with the use of Zoledronic acid – symptoms include pain in the jaw or the mouth, mouth sores, loose tooth, heaviness or numb feeling of the jaw, any discharge from the mouth. This is a serious condition and usually occurs after a dental procedure in people who have or taking treatment for cancer. Even otherwise, caution is advised and you are advised to consult the doctor promptly, also if you notice the slightest of symptoms...
- Allergic reaction like - fever, chills, rash, hives, breathing difficulty, swelling over your face, lips, throat
- Fainting, slow breathing; fast breathing or heartbeats, headache, chest pain
- Fever, swollen glands, chills, flu-like symptoms, cold, sudden weakness
- Sore skin, easy bruising, bleeding, itching, numbness, muscle weakness and pain
- Problems with urination indicating kidney problem- little, no urine, painful, difficult urination
- Skin reaction- fever, swelling on face and tongue, sore throat, burning skin and eyes, purple and red rash on the skin which later starts peeling and scaling
- Nausea, vomiting, diarrhea, constipation
- Back pain, joint and muscle pain, weakness
- Dizziness, drowsiness, tiredness
- Loss of appetite, weight loss, stomach pain
- Sore throat, cough
Precautions and Warnings of Zoledronic Acid
Pregnancy
Q:
Can I take Zoledronic Acid during pregnancy?
A:
Not enough data is available. Zoledronic Acid should not be used during pregnancy as it has the potential to harm the unborn baby
Breast Feeding
Q:
Can I take Zoledronic Acid while breastfeeding?
A:
Sufficient data is lacking and it is not known with certainty if Zoledronic Acid is secreted in breast milk. It is best advised to avoid this medicine in breastfeeding women.
Driving
Q:
Can I drive if I have consumed Zoledronic Acid?
A:
This medicine may cause problems with your vision or dizziness. Exercise caution if you experience any such side effects.
Alcohol
Q:
Can I consume alcohol with Zoledronic Acid?
A:
Alcohol may not directly interact with Zoledronic Acid but may increase the risk for fractures. It is advised to minimize alcohol consumption (to occasional drinking) while taking this medicine. Avoid alcohol for at least two weeks before and after treatment.
Other General Warnings
Talk to your doctor if
- Inform the doctor if any of the following applies to you:
- Taking any other treatment containing Zoledronic Acid
- Surgery of parathyroid glands (specialized tissue in the neck that control calcium levels in the body) or intestines
- Kidney problems
- If you cannot take daily calcium supplements, you have cancer or you are taking medicines that suppress immune response (Corticosteroids – Prednisolone, Dexamethasone)
Mode of Action of Zoledronic Acid
How Does It Work?
Zoledronic Acid works by attaching to bone minerals, preventing them from break down. This will reduce bone loss and decreases the risk of fractures. When this is combined with calcium or vitamin D intake, the bone can be strengthened....
Interactions of Zoledronic Acid
Interactions with other medicines
- Use the following medicines with caution:
- Any medicines that can cause kidney damage - Diuretics or water pills (Spironolactone, Triamterene, etc.), Aminoglycoside antibiotics (Amikacin, Gentamicin, Neomycin, etc.), pain killers (Ibuprofen, Diclofenac), etc....
- Other forms of Bisphosphonates
- Medicines that suppress immune response (Corticosteroids – Prednisolone, Dexamethasone)
- Do not mix Zoledronic acid with IV fluids containing calcium (Ringer’s solution, parenteral nutrition)
- Inform your doctor about all other medicines, supplements or herbs you are taking
Interactions with food items
Zoledronic Acid infusion can be taken before or after food.
Dietary Restrictions of Zoledronic Acid
Drink plenty of fluids, starting at least a week before and up to 2 weeks after the treatment. You can have your regular diet on the day of surgery.
Dosage of Zoledronic Acid
Overdose
An overdose is unlikely as healthcare professionals will give you the medicine as an injection. Excess Zoledronic Acid may cause muscle weakness, stiffness and aches, low calcium levels and may increase the risk of fractures. Consult your doctor in case of such symptoms. Calcium supplementation usually helps with these symptoms....
Missed a Dose
Zoledronic Acid is usually taken once a year under medical supervision. If you miss a dose, call the doctor and take the missed dose as soon as you can.
Content Details
WRITTEN BY

Dr. Nikita Toshi
BDS (Bachelor of Dental Surgery), WHO FIDES member
REVIEWED BY

Dr. Ritu Budania
MBBS, MD (Pharmacology)
Frequently Asked Questions (FAQs)
Q: What are Bisphosphonates? Are they better than other medicines for bone loss?
- Bisphosphonates are substances that are naturally made in the body and they primarily strengthen the bone (increase the density of the bone). They do this mainly by preventing the breakdown of the bone. Hence, calcium and Vitamin D supplementation is necessary while taking Bisphosphonates, as these can help the substance of the bone to regrow...
- Osteoporosis is thinning of bone due to the death of bone cells which is usually age-related. For such patients, when Bisphosphonates are given, they penetrate the bone and stop the bone cells from dying. In normal conditions, our bone strength is a balance between bone loss and bone growth...
- In old aged people and certain diseases (like cancers), there is only bone loss, but the bone does not grow which leads to thinning of the bone and increases the risk of fractures
- Bisphosphonates are phosphates which prevent bone loss. In these conditions and with calcium and Vitamin D supplementation, bone strength can be restored
- Bisphosphonate injections are usually safe but they are not given in all patients with bone loss. They are generally reserved for patients who cannot tolerate the tablets or those at high risk for fractures...
- Bisphosphonates are also used to treat certain types of cancer
Q: Anything else I must know before taking Zoledronic Acid?
- The frequency of administration of Zoledronic Acid varies depending on the condition of the patients. For some diseases, it is given once a year, and for some others as a single dose
- Retreatment may be necessary, but in any case, the usual frequency is once in a year. So, there is no problem of overdose or missed dose
- Adequate calcium and Vitamin D supplementation is necessary to derive maximum benefit from Zoledronic Acid. Calcium can be taken in the form of tablets every day, but injections may be required for Vitamin D...
- Zoledronic Acid is given as a slow intravenous drip (through the veins), for a period not less than 15 minutes
- Quit smoking, maintain good oral health, have regular dental check-ups and inform the doctor if you have any cancers or previously treated with Bisphosphonates
- Zoledronic Acid should not be used in patients with severe kidney disease or those less than 18 years of age
- Never self-administer this medicine. Zoledronic Acid must always be taken under medical supervision
References
View All
- EMC. Zoledronic acid. [accessed on 26 Sep, 2019]
- EMC. Zoledronic acid. [accessed on 26 Sep, 2019]
- Webmd. Zoledronic acid. [accessed on 2.Sep.2019]
- Mayoclinic. Zoledronic acid. [accessed on 2.Sep.2019]
- Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Zoledronic Acid. [Updated 2018 Dec 3]
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