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Zometa

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...

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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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One-shot treatment for stronger bones
From Nursing, 5/1/02

OSTEOPOROSIS

Administered intravenously (I.V.), a potent bisphosphonate may effectively treat osteoporosis with only a single dose per year. A recent study showed that one infusion a year of zoledronic acid (Zometa) increased bone density as well as daily oral doses or more-frequent LV. doses.

In the yearlong study involving 351 patients in New Zealand, Europe, and Canada, researchers studied the effects of zoledronic acid on bone turnover and density in postmenopausal women with low bone mineral density. The zoledronic acid regimens studied included daily oral doses, LV. doses at 3- and 6-- month intervals, and a single 4-mg LV. infusion. Some women in each study group received a placebo.

At the end of the study, the bone density gains in women who received just one 4-mg I.V. dose of zoledronic acid were comparable with those of women who took the drug in one of the other oral or LV. regimens. Women taking zoledronic acid by any regimen improved significantly over those taking a placebo, and the benefits persisted for at least a year after treatment ended.

Although effective at treating osteoporosis, oral zoledronic acid can cause adverse reactions such as abdominal or esophageal pain, heartburn, and nausea, and the need for frequent dosing on an empty stomach can reduce compliance. Calling the possibility of a single annual treatment for osteoporosis "a huge change," lead researcher Dr. Ian Reid of the University of Auckland, New Zealand, says, "I think it almost comes into the category of a flu shot, rather than taking pills every day and having side effects."

Novartis Pharmaceuticals Corp., which makes Zometa and sponsored this study, has begun much larger and longer studies of the drug's potential for treating and preventing osteoporosis.

Source: "Intravenous Zoledronic Acid in Postmenopausal Women with Low Bone Mineral Density," The New England Journal of Medicine, I. Reid, et al., February 28, 2002.

Copyright Springhouse Corporation May 2002
Provided by ProQuest Information and Learning Company. All rights Reserved

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