Zoledronic acid

Pronunciation

ZOH-leh-DRAH-nik A-sid

Indications

zoledronic acid is a drug used to treat hypercalcemia caused by cancer.

Zoledronic acid

Used with chemotherapy

It is also used with other anticancer drugs to treat multiple myeloma and cancers that have spread to the bone.

Other cancers

It is also being studied in the treatment of other types of cancer.

Mechanism of action

Zoledronic acid may help keep bone from breaking down and prevent the loss of calcium from the bones.

Pharmacology

It is a type of bisphosphonate.

Other names

Also called zoledronate

Brand name

Zometa

Hypercalcemia of malignancy

• • patients with multiple myeloma and patients with documented bone metastases from solid tumors, in conjunction with standard antineoplastic therapy. Prostate cancer should have progressed after treatment with at least one hormonal therapy.

Dosage and administration

Hypercalcemia of malignancy

• 4 mg as a single-use intravenous infusion over no less than 15 minutes.
• 4 mg as retreatment after a minimum of 7 days.

Multiple myeloma and bone metastasis from solid tumors.

• 4 mg as a single-use intravenous infusion over no less than 15 minutes
• Every 3-4 weeks for patients with creatinine clearance of greater than 60 ml/min.

Renal dose adjustment

Reduce the dose for patients with renal impairment.

Calcium supplementation

• Co-administer oral calcium supplements of 500 mg and a multiple vitamin
• Containing 400 international units of vitamin d daily.
• Administer through a separate vented infusion line and do not allow to come
• In contact with any calcium or divalent cation-containing solutions.

Dosage forms

4 mg/100 ml single-use ready-to-use bottle 4 mg/5 ml single-use vial of concentrate

Contraindications

Hypersensitivity to any component of zometa

Warnings

• patients being treated with zometa should not be treated with reclast®.
• adequately rehydrate patients with hypercalcemia of malignancy prior to
• Administration of zometa and monitor electrolytes during treatment.
• Discontinue zometa if severe symptoms occur.

Zoledronic-acid

Renal adjustment

• renal toxicity may be greater in patients with renal impairment.
• Do not use doses greater than 4 mg.
• Treatment in patients with severe renal impairment is not recommended.
• Monitor serum creatinine before each dose.

Osteoporosis of the jaw

• osteonecrosis of the jaw has been reported. Preventive dental exams should be performed before starting zometa. Avoid invasive dental procedures.
• severe incapacitating bone, joint, and/or muscle pain may occur.
• zometa can cause fetal harm. Women of childbearing potential should be advised of the potential hazard to the fetus and to avoid becoming pregnant.
• atypical subtrochanteric and diaphyseal femoral fractures have been reported in patients receiving bisphosphonate therapy. These fractures ma occur after minimal or no trauma. Evaluate patients with thigh or groin pain to rule out a femoral fracture. Consider drug discontinuation in patients suspected to have an atypical femur fracture.
• hypocalcemia: correct before initiating zometa. Adequately supplement patients with calcium and vitamin D

Side effects

• The most common adverse events (greater than 25%) were nausea, fatigue, anemia, bone pain, constipation, fever, vomiting, and dyspnea

Drug interactions

• Aminoglycosides: may have an additive effect to lower serum calcium for prolonged periods.
• Loop diuretics: concomitant use with zometa may increase risk of hypocalcemia.
• Nephrotoxic drugs: use with caution.

Nursing mothers

• Nursing mothers: it is not known whether zometa is excreted in human milk.

Pediatric use

• Pediatric use: not indicated for use in pediatric patients.

Geriatric use

• Geriatric use: special care to monitor renal function.

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