zoledronic acid monohydrate at a glance
Medicine class
Nitrogen-containing bisphosphonate
Licensed uses
Osteoporosis in specified adults at increased fracture risk, including glucocorticoid-associated osteoporosis, and Paget’s disease of bone
Administration
Given into a vein by a healthcare professional
Before treatment
Kidney function, hydration and calcium status require assessment; dental risk may also need review
What is zoledronic acid monohydrate used for?
The selected product is licensed for:
Osteoporosis in postmenopausal women at increased fracture risk, including after a recent low-trauma hip fracture
Osteoporosis in adult men at increased fracture risk, including after a recent low-trauma hip fracture
Osteoporosis associated with long-term systemic glucocorticoid treatment in postmenopausal women and adult men at increased fracture risk
Paget’s disease of bone in adults
How does zoledronic acid monohydrate work?
Zoledronic acid binds strongly to mineralised bone and is taken up by osteoclasts, the cells that remove old bone. It inhibits farnesyl pyrophosphate synthase within these cells, reducing bone resorption and helping to regulate abnormal bone turnover.
zoledronic acid monohydrate preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 4 mg/100 mL, 4 mg/5 mL, 5 mg, 5 mg/100 mL
How to take zoledronic acid monohydrate
A doctor or nurse administers the ready-to-use solution through a vein. Food can be eaten normally on the treatment day. Follow the clinical team’s instructions about drinking fluids and taking calcium or vitamin D, and tell them about acute illness, dehydration, kidney problems or planned dental procedures before attending.
Do not attempt to administer the infusion yourself.
Maintain good oral hygiene and tell your dentist that you receive zoledronic acid.
Do not drive or use machinery if dizziness occurs.
zoledronic acid monohydrate side effects
Common or expected effects
- Fever, chills or flu-like symptoms
- Headache or dizziness
- Muscle, joint, bone, back or limb pain
- Tiredness, weakness or feeling generally unwell
- Nausea, vomiting or diarrhoea
- Pain or swelling at the infusion site
Get urgent medical advice
- Severe allergic reaction, including breathing difficulty or face and throat swelling
- Kidney injury, which may cause reduced urine or blood in the urine
- Low blood calcium, potentially causing spasms, numbness or tingling
- Painful red or light-sensitive eyes
- Jaw osteonecrosis, with pain, swelling, loose teeth or non-healing sores
- Atypical thigh-bone fracture, sometimes preceded by thigh, hip or groin pain
- New palpitations or symptoms of an irregular heartbeat
zoledronic acid monohydrate in pregnancy
The selected product is contraindicated during pregnancy and is not recommended for women who could become pregnant. Evidence from human pregnancies is limited, and bisphosphonates remain stored in bone; anyone planning a pregnancy or becoming pregnant after exposure should discuss this with their prescriber or maternity team.
zoledronic acid monohydrate while breastfeeding
The selected product is contraindicated while breastfeeding. It is not known whether zoledronic acid passes into human milk, so specialist or prescriber advice is required if treatment is being considered.
zoledronic acid monohydrate interactions
Provide a complete medicines list before treatment, including non-prescription products.
Aminoglycosides and other medicines that can impair kidney function
Concurrent use may increase renal risk and requires careful assessment and monitoring.
Diuretics that can cause dehydration
Dehydration can increase the risk of kidney injury, particularly in older adults.
Other zoledronic acid products or bisphosphonates
They should not be used concurrently because their combined effects are unknown.
Common questions about zoledronic acid monohydrate
Answers are fully visible for fast scanning and source review.
Why are blood tests needed before zoledronic acid monohydrate?
Kidney function must be checked because the medicine is cleared through the kidneys and can occasionally cause renal injury. Calcium and related mineral abnormalities may also need assessment and correction.
Why is dental health important with zoledronic acid monohydrate?
Zoledronic acid can rarely be associated with jaw osteonecrosis. Good oral hygiene, routine dental care and early reporting of mouth or jaw symptoms help reduce or manage this risk.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.