Zoledronic acid (Injection)

Introduction:

Zoledronic Acid (zoe-le-DRON-ik AS-id)

Treats high blood calcium levels (hypercalcemia) that sometimes occur in patients with cancer. Also treats bone damage caused by Paget's disease, multiple myeloma, and cancers that spread to the bone. Also treats osteoporosis (thinning of the bone) in men and in women who have gone through menopause. Reduces the risk of having more fractures in patients who had a recent hip fracture. This medicine is a bisphosphonate.

Brand Name(s):

Reclast, Zometa

When This Medicine Should Not Be Used:

How to Use This Medicine:

Injectable

• A nurse or other trained health professional will give you this medicine.
• Your doctor will prescribe your exact dose and tell you how often it should be given. This medicine is given through a needle placed in one of your veins. It will take at least 15 minutes for you to receive one dose of this medicine.
• For hypercalcemia, this medicine is usually given only once. If your doctor decides that you need additional doses, you will receive the medicine again after at least 7 days have passed. This treatment will continue until your body responds to the medicine.
• For bone cancer, this medicine is usually given every 3 to 4 weeks. This treatment will continue until your body responds to the medicine.
• For osteoporosis, this medicine is usually given once a year and will continue until your body responds to the medicine.
• You may also receive other medicines to help keep your body from losing too much fluid.
• Drink extra fluids so you will pass more urine while you are using this medicine. This will keep your kidneys working well and help prevent kidney problems. However, it is very important to not drink too much liquid. Talk to your doctor about the right amount of liquids for you.
• Your doctor may also give you Vitamin D and calcium supplements. Tell your doctor if you are unable to take these medicines.

If a dose is missed:

• This medicine needs to be given on a fixed schedule. If you miss a dose, call your doctor, home health caregiver, or treatment clinic for instructions.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are also using thalidomide (Thalomid®) or medicine to treat an infection (such as amikacin, gentamicin, streptomycin, tobramycin, Amikin®, or Garamycin®).
• Do not use other medicines that also contain zoledronic acid (Zometa®), or diuretics or "water pills" (such as furosemide, torsemide, Demadex®, or Lasix®) unless your doctor tells you to. Tell your doctor if you are also using a pain or arthritis medicine, sometimes called "NSAIDs" (such as aspirin, ibuprofen, naproxen, Advil®, Aleve®, Bextra®, or Voltaren®).

Warnings While Using This Medicine:

• Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.
• Make sure your doctor knows if you have kidney disease, congestive heart failure, aspirin-sensitive asthma (asthma that is brought on by aspirin sensitivity), parathyroid problems, or stomach absorption problems. Also tell your doctor if you have had surgery on your parathyroid or thyroid gland, or if you have had portions of your bowel removed.
• Your doctor will need to know if you have a history of problems with your mouth or teeth (such as gum disease). Make sure your doctor knows if you have been treated with a bisphosphonate medicine, such as alendronate (Fosamax®), etidronate (Didronel®), pamidronate (Aredia®), risedronate (Actonel®), or tiludronate (Skelid®), in the past.
• You may need to have a dental exam before you start using this medicine.
• Make sure any doctor or dentist who treats you knows that you are using this medicine, especially if you are having dental surgery. You should avoid having major dental work done while you are being treated with this medicine.
• Your doctor will need to check your blood or urine at regular visits while you are using this medicine. Be sure to keep all appointments.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.
• Chest pain.
• Decrease in how much or how often you urinate.
• Dry mouth, increased thirst, or muscle cramps.
• Fast, slow, or uneven heartbeat.
• Fever, chills, cough, sore throat, and body aches.
• Loss of appetite, nausea, vomiting, sleepiness, or changes in personality.
• Muscle weakness, spasm, or tremor.
• Numbness and tingling around the mouth.
• Pain or other problems with your teeth or jaw.
• Pale skin.
• Rapid weight gain.
• Severe muscle, bone, or joint pain.
• Swelling in your hands, ankles, or feet.
• Trouble with breathing.
• Unusual bleeding or bruising.
• Unusual tiredness or weakness.

If you notice these less serious side effects, talk with your doctor:

• Headache, dizziness, or trouble sleeping.
• Mild nausea, diarrhea, constipation, or upset stomach.
• Mild skin rash or itching.
• Numbness, tingling, or burning pain in your hands, arms, legs, or feet.
• Redness, irritation, or pain in your eyes.
• Redness, pain, or swelling of your skin where the needle is placed.
• Sores or white patches on your lips, mouth, or throat.

If you notice other side effects that you think are caused by this medicine, tell your doctor: