What is the most important information I should know about zoledronic acid?
Do not use if you are pregnant. Use effective birth control, and ask your doctor how long to prevent pregnancy after you stop using zoledronic acid.
Zoledronic acid can cause serious kidney problems, especially if you are dehydrated, if you take diuretic medicine, or if you already have kidney disease. Call your doctor if you urinate less than usual, if you have swelling in your feet or ankles, or if you feel tired or short of breath.
Also call your doctor if you have muscle spasms, numbness or tingling (in hands and feet or around the mouth), new or unusual hip pain, or severe pain in your joints, bones, or muscles.
What is zoledronic acid?
Reclast and Zometa are two different brands of zoledronic acid.
Reclast is used to treat or prevent osteoporosis caused by menopause, or steroid use. This medicine also increases bone mass in men with osteoporosis. Reclast is for use when you have a high risk of bone fracture.
Reclast is also used to treat Paget's disease of bone.
Zometa is used to treat high blood levels of calcium caused by cancer (also called hypercalcemia of malignancy). This medicine also treats multiple myeloma (a type of bone marrow cancer) or bone cancer that has spread from elsewhere in the body.
You should not use Reclast and Zometa at the same time.
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 be treated with zoledronic acid if you are allergic to it.
You also should not receive Reclast if you have:
- low levels of calcium in your blood (hypocalcemia); or
- severe kidney disease.
You should not be treated with zoledronic acid if are currently using any other bisphosphonate (such as alendronate, etidronate, ibandronate, pamidronate, risedronate, or tiludronate).
Tell your doctor if you have ever had:
- kidney disease;
- thyroid or parathyroid surgery;
- surgery to remove part of your intestine;
- asthma caused by taking aspirin;
- any condition that makes it hard for your body to absorb nutrients from food (malabsorption);
- a dental problem (you may need a dental exam before you receive zoledronic acid);
- if you are dehydrated; or
- if you take a diuretic or "water pill".
Zoledronic acid can cause serious kidney problems, especially if you are dehydrated, if you take diuretic medicine, or if you already have kidney disease.
This medicine may cause jaw bone problems (osteonecrosis). The risk is highest in people with cancer, blood cell disorders, pre-existing dental problems, or people treated with steroids, chemotherapy, or radiation. Ask your doctor about your own risk.
You may need to have a negative pregnancy test before starting this treatment.
Do not use if you are pregnant. This medicine may harm an unborn baby or cause birth defects. Zoledronic acid can remain in your body for weeks or years after your last dose. Use effective birth control to prevent pregnancy while using this medicine. Talk with your doctor about the need to prevent pregnancy after you stop using zoledronic acid.
This medicine may affect fertility (ability to have children) in women. However, it is important to use birth control to prevent pregnancy because zoledronic acid can harm an unborn baby.
You should not breastfeed while using zoledronic acid.
How is zoledronic acid given?
Zoledronic acid is given as an infusion into a vein. A healthcare provider will give you this injection.
Zoledronic acid is sometimes given as a single dose only one time. It may also be given once every 1 or 2 years. How often you receive zoledronic acid will depend on why you are using this medicine. Follow your doctor's instructions.
Drink at least 2 glasses of water within a few hours before your injection to keep from getting dehydrated.
You will need frequent medical tests.
Pay special attention to your dental hygiene while using zoledronic acid. Brush and floss your teeth regularly. If you need to have any dental work (especially surgery), tell the dentist ahead of time that you are using zoledronic acid.
Zoledronic acid is only part of a complete program of treatment that may also include diet changes and taking calcium and vitamin supplements. Follow your doctor's instructions very closely.
Your doctor will determine how long to treat you with this medicine. Zoledronic acid is often given for only 3 to 5 years.
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 smoking, or try to quit. Smoking can reduce your bone mineral density, making fractures more likely.
Avoid drinking large amounts of alcohol. Heavy drinking can also cause bone loss.
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:
- new or unusual pain in your thigh or hip;
- jaw pain or numbness, red or swollen gums, loose teeth, or slow healing after dental work;
- severe joint, bone, or muscle pain;
kidney problems --little or no urination, swelling in your feet or ankles, feeling tired;
low red blood cells (anemia) --pale skin, unusual tiredness, feeling light-headed or short of breath, cold hands and feet; or
low calcium levels --muscle spasms or contractions, numbness or tingly feeling (around your mouth, or in your fingers and toes).
Serious side effects on the kidneys may be more likely in older adults.
Common side effects may include:
- trouble breathing;
- nausea, vomiting, diarrhea, constipation;
- bone pain, muscle or joint pain;
- fever or other flu symptoms;
- eye pain or swelling;
- pain in your arms or legs;
- headache; or
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, especially if you also use certain medicines for infections, cancer, osteoporosis, organ transplant rejection, bowel disorders, high blood pressure, or pain or arthritis (including Advil, Motrin, and Aleve).
Other drugs may affect zoledronic acid, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines 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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