Zoledronic Acid

Drugs affecting Bone Metabolism · Bisphosphonate

Indications

Treatment of post-menopausal osteoporosis and osteoporosis in men. Treatment of Paget's disease of bone.

Dosage

Adults: INJECTION 5 MG: Treatment of post-menopausal osteoporosis and osteoporosis in men: By IV infusion 5 mg over at least 15 min once a yr. In patients with a recent low-trauma hip fracture, the dose should be given 2 or more wk following hip fracture repair; before first infusion give 50000-125000 units of vitamin D. Treatment of Paget's disease of bone: By IV infusion 5 mg as a single dose, over at least 15 min. At least 500 mg elemental calcium twice daily (with vitamin D) for at least 10 days is recommended following infusion. Adults: INJECTION 4 MG: Reduction of bone damage in advanced malignancies involving bone: By IV infusion, 4 mg over at least 15 min every 3-4 wk. Calcium 500 mg and vit D 400 units daily should be taken. Hypercalcaemia of malignancy: By IV infusion: 4 mg as single dose over at least 15 mins. Children: Not recommended.

Administration

IV: In order to prevent renal toxicity, infuse soln over at least 15 min. Reconstitution: Powder for reconstitution: Reconstitute in SWFI. Once fully dissolved, further dilute in 100 mL NS or D5W prior to administration. Infusion of solution must be completed within 24 hours of initial reconstitution of powder. Solution for injection: Dilute in 100 mL NS or D5W prior to administration, Infusion of solution must be completed within 24 hours. Compatibility: Incompatible with calcium-containing solutions (e.g. LR). Stability: Vial: Inj 5 mg: Store at room temperature of 15°C-30°C. Inj 4 mg: Store concentrated vial and ready to use bottles at 25°C; excursions permitted to 15°C-30°C. Reconstituted solution: For infusion (diluted in 100 mL NS or D5W prior to administration) which is not used immediately. After preparation should be refrigerated at 2°C-8°C. Ready-to-use bottle: no further…

Adverse Effects

Hypophosphataemia, hypocalcaemia, creatinine/urea increase, anaemia, headache, conjunctivitis, nausea, vomiting, fatigue, fever, taste perversion, bone pain, arthralgia, myalgia, renal impairment, thirst, pancytopenia, bradycardia, dizziness, ocular hyperaemia, GI upset, anorexia, flu like symptoms, asthenia, musculoskeletal pain, generalised pain, atrial fibrillation, inj site reaction, raised C-reactive protein, acute phase reaction.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Contraindications: Hypersensitivity to other bisphosphonate. Severe renal impairment, hypocalcaemia. Precautions: Severe hepatic impairment. Cardiac failure. Monitor serum calcium, phosphate, magnesium and renal function. Ensure adequate hydration, calcium and vit D intake.

Interactions

Aminoglycosides, thalidomide, other nephrotoxic agents or bisphosphonates, calcitonin, diuretics, anti-angiogenic drugs.

Advice to Patient

This medication is administered intravenously. During infusion and for 2-3 hours after administration, avoid taking vitamins. Inform prescriber if you have to undergo a dental surgery. Contact prescriber if you experience muscle spasms, unusual muscle twitching, severe diarrhoea or constipation, acute bone pain. Take diet containing sufficient amount of vitamin D and calcium. If you have recurrent bone pain, consult prescriber for analgesic. Have blood tests done as recommended by prescriber.

Pharmacokinetics

Metabolism: Primarily eliminated intact via the kidney; metabolism not likely. Half-life elimination: Triphasic; Terminal: 146 hours. Excretion: Urine (39% ± 16% as unchanged drug) within 24 hours; feces (<3%).

Brands with this active ingredient

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.