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ZOLEDRONIC ACID

About

ZOLEDRONIC ACID belongs to the class of medicines called 'bisphosphonates' used to treat osteoporosis (weak and brittle bones) caused by menopause or long-term steroid use. ZOLEDRONIC ACID also treats Paget’s bone and high calcium levels caused by cancer. Osteoporosis is a bone disease that weakens and thins bones by decreasing bone density, common in post-menopausal women.  As the density of bones decreases, they weaken and are more likely to break. 

ZOLEDRONIC ACID contains Zoledronic acid that works by binding to the bone tightly and preventing the removal of calcium by osteoclasts (a type of bone cell that destroys bone tissue). This prevents osteoclasts from breaking down the bone and keeps the bones strong and minimizes the risk of bones breaking.

A doctor or nurse will administer ZOLEDRONIC ACID. In some cases, you may experience headache, fever, nausea, dizziness, vomiting, back pain, diarrhea, pain in the muscles, joints, or bones, swelling, or pain at the infusion site. Most of these side effects of ZOLEDRONIC ACID do not require medical attention and gradually resolve over time. However, if the side effects persist or worsen, please consult your doctor.

If you are allergic to ZOLEDRONIC ACID or any other medicines, please tell your doctor. Avoid taking ZOLEDRONIC ACID if you are pregnant or breastfeeding and consult a doctor. ZOLEDRONIC ACID is not recommended for children below 18 years as the safety and effectiveness were not established. Avoid taking ZOLEDRONIC ACID if you have hypocalcemia (low calcium levels in the blood) and severe kidney problems. Drive only if you are alert as ZOLEDRONIC ACID may cause dizziness. ZOLEDRONIC ACID may cause osteonecrosis of the jaw (ONJ) in some patients. Therefore, if you experience any problems with teeth or mouth such as loose teeth, swelling or pain, non-healing of sores, or discharge, consult your doctor and dentist as these might be signs of osteonecrosis of the jaw.

Uses of ZOLEDRONIC ACID

Treatment of Postmenopausal osteoporosis, Pagets disease, Hypercalcemia (high level of calcium) in cancer

Medicinal Benefits

ZOLEDRONIC ACID contains Zoledronic acid used to treat postmenopausal osteoporosis, Paget’s disease, and hypercalcemia of malignancy (bone cancer in which excess of calcium exits). ZOLEDRONIC ACID binds to the bone tightly and prevents calcium removal by osteoclasts (a type of bone cell that destroy bone tissue). This prevents osteoclasts from breaking down the bone, strengthening bones, and minimizing the risk of bones breaking. Also, ZOLEDRONIC ACID may reduce calcium levels in the blood by preventing calcium reabsorption from bones to the blood. Thus, it helps in treating high calcium levels in the blood caused by cancer.

Directions for Use

ZOLEDRONIC ACID will be administered by a healthcare professional; do not self-administer.

Storage

Store in a cool and dry place away from sunlight

Side Effects of ZOLEDRONIC ACID

  • Headache
  • Fever
  • Nausea
  • Dizziness
  • Vomiting
  • Back pain
  • Diarrhoea
  • Flu-like symptoms (chills, tiredness, muscle, and joint pain)
  • Pain in the muscles, joints, or bones
  • Swelling or pain at the infusion site

In-Depth Precautions and Warning

Drug Warnings

If you are allergic to ZOLEDRONIC ACID or any other medicines, please tell your doctor. Avoid taking ZOLEDRONIC ACID if you are pregnant or breastfeeding and consult a doctor. ZOLEDRONIC ACID is not recommended for children below 18 years as the safety and effectiveness were not established. Avoid taking ZOLEDRONIC ACID if you have hypocalcemia (low calcium levels in the blood) and severe kidney problems. Drive only if you are alert as ZOLEDRONIC ACID may cause dizziness. If you are not able to take daily calcium supplements, have had sections of the intestine or some or all of the parathyroid glands in the neck surgically removed, have cancer, gum disease, poor dental health, or planned tooth extraction or kidney problem, inform your doctor before taking ZOLEDRONIC ACID. If you are a smoker, inform your doctor before receiving ZOLEDRONIC ACID as it may increase the risk of dental problems. ZOLEDRONIC ACID may cause osteonecrosis of the jaw (ONJ) in some patients. Therefore, if you experience any problems with teeth or mouth such as loose teeth, swelling or pain, non-healing of sores, or discharge, consult your doctor and dentist as these might be signs of osteonecrosis of the jaw. You are recommended to drink at least 2 glasses of fluids before and after treatment with ZOLEDRONIC ACID as advised by your doctor to prevent dehydration. Take calcium and vitamin D supplements as prescribed by your doctor as ZOLEDRONIC ACID may reduce calcium levels in the blood.

Drug Interactions

Drug-Drug Interaction: ZOLEDRONIC ACID may interact with antibiotics (gentamicin) and water pills (furosemide).

Drug-Food Interaction: No interactions found.

Drug-Disease Interaction: Avoid taking ZOLEDRONIC ACID if you have hypocalcemia (low calcium levels in the blood) and severe kidney problems. If you have cancer, gum disease, poor dental health, or planned tooth extraction or kidney problem, inform your doctor before taking ZOLEDRONIC ACID.

Drug-Drug Interactions Checker List:

  • GENTAMICIN
  • FUROSEMIDE
  • Safety Advice

    • Safety Warning

      Alcohol

      caution

      Interaction of alcohol with ZOLEDRONIC ACID is unknown. Please consult a doctor before consuming alcohol with ZOLEDRONIC ACID.

    • Safety Warning

      Pregnancy

      unsafe

      ZOLEDRONIC ACID is a category D pregnancy drug and is not recommended for pregnant women as it may harm an unborn baby. Please consult a doctor if you are pregnant.

    • Safety Warning

      Breast Feeding

      unsafe

      ZOLEDRONIC ACID is contraindicated in breastfeeding mothers. Therefore, please consult a doctor if you are breastfeeding.

    • Safety Warning

      Driving

      caution

      ZOLEDRONIC ACID may cause dizziness. Therefore, avoid driving or operating machinery if you feel dizzy after taking ZOLEDRONIC ACID.

    • Safety Warning

      Liver

      caution

      Take ZOLEDRONIC ACID with caution, especially if you have a history of Liver diseases/conditions. The dose may be adjusted by your doctor as required.

    • Safety Warning

      Kidney

      caution

      Take ZOLEDRONIC ACID with caution, especially if you have a history of Kidney diseases/conditions. The dose may be adjusted by your doctor as required. Avoid taking ZOLEDRONIC ACID if you have severe kidney problems.

    • Safety Warning

      Children

      unsafe

      ZOLEDRONIC ACID is not recommended for children below 18 years as the safety and effectiveness were not established.

    Habit Forming

    No

    Diet & Lifestyle Advise

    • Include dairy products like milk, yoghurt, cheese, or milk-based custard in your diet.
    • Eat daily a serving of broccoli, cabbage, bok choy (Chinese white cabbage), spinach, and other green leafy vegetables.
    • Snack on calcium-rich nuts like Brazil nuts or almonds.
    • Sprinkle sesame seeds over your food, vegetables, and salads. Sesame seeds are high in calcium.
    • Avoid or reduce the intake of caffeine, soft drinks, and alcohol that inhibit calcium absorption.
    • Replace the meat with tofu or tempeh for extra calcium in your food.

    Special Advise

    • A preventive dental check-up is required before using ZOLEDRONIC ACID as it has been reported to cause osteonecrosis of the jaw. 
    • A blood test is recommended before taking each dose of ZOLEDRONIC ACID to monitor kidney functioning. 
    • Regular intake of calcium and vitamin D may be recommended by your doctor while taking treatment with ZOLEDRONIC ACID. 
    • While using ZOLEDRONIC ACID, you may experience musculoskeletal pain, in this case, stop taking ZOLEDRONIC ACID and consult a doctor. 

    Patients Concern

    Disease/Condition Glossary

    Osteoporosis: It is a bone disease that weakens and thins bones by decreasing bone density.  As the density of bones decreases, they weaken and are more likely to break. Post-menopausal women are more likely to develop osteoporosis than men because, at menopause, women’s ovaries stop producing estrogen (a female hormone) essential to keeping bones healthy. Following menopause, bone loss occurs, making bones weak and more likely to break. Also, long-term use of steroids may affect bone strength and cause osteoporosis in both men and women. Signs and symptoms include back pain caused by a fractured or collapsed vertebra, loss of height over time, a stooped posture, and a bone that breaks much more easily than expected.

    Paget’s disease: In Paget’s disease, bone remodeling (removal of old bone and replacement with new bone material) is too quick, and new bone is formed in a disordered manner making it weaker than normal. If left untreated, the bone may become deformed, painful, and broken.

    Hypercalcemia in cancer: In some cancers like breast cancer, lung cancer, or blood cancer, there is too much calcium level in the bloodstream. A patient suffering from a high level of calcium might include nausea, vomiting, constipation, headache, and loss of appetite. 

    FAQs

    ZOLEDRONIC ACID is used to treat osteoporosis (weak and brittle bones) and Paget's bone.

    ZOLEDRONIC ACID contains Zoledronic acid that works by binding to the bone tightly and preventing the removal of calcium by osteoclasts (a type of bone cells that destroy bone tissue). This prevents osteoclasts from breaking down the bone and keeps the bones strong and minimizes the risk of bones breaking.

    You are not recommended to take ZOLEDRONIC ACID if you have hypocalcemia (low levels of calcium in the blood) as it may worsen the condition. However, the levels of calcium and vitamin D may be checked before starting treatment with ZOLEDRONIC ACID.

    ZOLEDRONIC ACID may cause osteonecrosis (bone damage) of the jaw. Therefore, to prevent such condition, maintain good oral hygiene and have regular dental check-ups while taking ZOLEDRONIC ACID. Also, is you wear dentures, make sure they fit properly. However, if you experience any problems with teeth or mouth such as loose teeth, swelling or pain, non-healing of sores or discharge, consult your doctor and dentist as these might be signs of osteonecrosis of the jaw.

    You are not recommended to take ZOLEDRONIC ACID with gentamicin as co-administration of these two medicines may increase the risk of very low calcium levels in the blood. However, please consult a doctor before taking ZOLEDRONIC ACID with other medicines.

    ZOLEDRONIC ACID may reduce calcium levels in the blood by preventing calcium reabsorption from bones to the blood. Therefore, your doctor may prescribe calcium and vitamin D supplements, and you may be advised to take them for at least 10 days after receiving ZOLEDRONIC ACID.

    ZOLEDRONIC ACID may cause flu-like symptoms (chills, tiredness, muscle and joint pain) in some patients as a common side effect. However, if the symptoms persist or worsen even after 2 weeks, please consult a doctor.

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    ZOLEDRONIC ACID

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