Zoledronic acid

Zoledronate (Zometa®, Novartis) is a bisphosphonate, used to prevent osteoporosis and skeletal fractures, particularly in patients with cancers such as multiple myeloma and prostate cancer. It can also be used to treat hypercalcemia, particularly hypercalcemia of malignancy. It can also be helpful for treating pain from bone metastases. more...

Administration

Usually 4 mg intravenously once a month when given for oncologic purposes. It is given once a year for treatment of osteoporosis.

Side effects

Side effects can include fatigue, anemia, muscle aches, fevers, and swelling in the feet or legs. Zoledronate can cause deterioration in renal function.

A rare complicaiton of zoledronate is osteonecrosis of the jaw. This has mainly been seen in patients with multiple myeloma treated with zoledronate (Durie et al 2005).

Contraindications

• Poor renal function (e.g. creatinine>3 mg/dL)
• Pregnancy

Reference

• Durie BG, Katz M, Crowley J. Osteonecrosis of the jaw and bisphosphonates. N Engl J Med 2005;353:99-102. PMID 16000365.

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