zoledronic acid at a glance
Medicine class
Bisphosphonate that inhibits bone resorption
Administration
Infusion into a vein by an experienced healthcare team
Important checks
Kidney function, hydration, calcium balance and dental health
What is zoledronic acid used for?
The selected product is licensed in adults for:
Preventing skeletal complications in advanced cancers involving bone, including fractures, spinal compression, and the need for radiotherapy or surgery to bone.
Treating high blood calcium caused by a tumour.
Some NHS cancer services use it after early breast cancer treatment in selected post-menopausal women to reduce recurrence or spread risk; this is outside the selected product’s listed indications.
How does zoledronic acid work?
It binds strongly to mineralised bone and inhibits osteoclasts, the cells that remove old bone. This reduces excessive bone breakdown and calcium release from bone.
zoledronic acid preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 4 mg/5 mL, 5 mg/100 mL
How to take zoledronic acid
Zoledronic acid is not swallowed. A healthcare professional dilutes it and gives it through a vein. Be adequately hydrated as directed, follow individual fluid advice if you have heart or kidney problems, and tell the team about dental problems and other medicines.
Attend arranged infusion appointments and blood tests.
Tell the team if you are unwell, dehydrated or passing less urine than usual.
Tell your dentist that you receive zoledronic acid and maintain good oral hygiene.
zoledronic acid side effects
Common or expected effects
- Fever, chills, fatigue or flu-like symptoms after an infusion
- Bone, muscle or joint pain
- Headache
- Nausea, vomiting, diarrhoea or reduced appetite
- Red or inflamed eyes
- Changes in kidney function or low calcium or phosphate on blood tests
Get urgent medical advice
- Breathing difficulty, facial or throat swelling, or collapse
- Muscle spasms, seizures, tingling or abnormal heartbeat suggesting severe low calcium
- Markedly reduced urine or acute kidney injury
- Jaw pain, swelling, loose teeth or a mouth sore that does not heal
- Eye pain, marked redness or blurred vision
- New persistent thigh, hip or groin pain
zoledronic acid in pregnancy
The selected product should not be used during pregnancy. Human safety data are inadequate and animal studies found reproductive toxicity. As bisphosphonates remain stored in bone, discuss pregnancy planning or pregnancy during or after treatment with a specialist.
zoledronic acid while breastfeeding
Breastfeeding is a contraindication for the selected product because it is unknown whether zoledronic acid enters human milk. Discuss alternatives or a feeding plan with the specialist before an infusion.
zoledronic acid interactions
The treatment team should review all prescribed, over-the-counter and complementary medicines.
Aminoglycoside antibiotics, calcitonin or loop diuretics
These may cause a deeper or more prolonged fall in blood calcium.
Potentially nephrotoxic medicines
Concurrent use may increase renal impairment risk.
Thalidomide
In people with multiple myeloma, combined treatment may further increase renal dysfunction risk.
Common questions about zoledronic acid
Answers are fully visible for fast scanning and source review.
Is zoledronic acid chemotherapy?
No. It is a bisphosphonate that acts mainly on bone, although it may be used alongside anticancer treatments.
Why are blood tests needed?
They check kidney function and mineral levels such as calcium, helping identify problems needing correction or review before treatment.
Why does my dentist need to know?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.