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What is Zoledronic Acid?

By K. K. Lowen
Updated May 17, 2024
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Zoledronic acid belongs to the bisphosphonate class of drugs that help prevent bone loss by thickening and slowing the breakdown of bones, as well as reducing the amount of calcium released by bones into the bloodstream. Doctors commonly prescribe the medication to patients with osteoporosis, Paget’s disease of bone, and certain types of cancer, such as multiple myeloma and prostate cancer. The medication may offer pain relief from bone metastases, which occur when cancer spreads into the bones. Its bone-strengthening properties may prevent the recurrence of hip fractures as well. As with most drugs, there are known side effects and patients should speak with a health care provider about preexisting health conditions before use.

The drug is available in liquid form, and the frequency of administration depends largely on the medical condition being treated. For cancer patients whose blood-calcium levels are high, a single injection may be sufficient to return the levels to normal. Similarly, a single injection may be adequate for people who suffer from Paget’s disease of bone, but they may receive additional injections if needed. When used to treat cancer-related bone disease, injections usually occur every three to four weeks. Those who suffer from osteoporosis may require a single shot annually.

A number of unwanted side effects may occur when using zoledronic acid, and patients should contact medical professionals for any severe reactions. Side effects include redness and swelling at the injection site, excessive worrying, agitation, depression, hair loss, mouth sores, weight loss, heart burn, and eye irritation. Patients also may experience flu-like symptoms such as nausea, vomiting, constipation, diarrhea, and stomach pain.

Some symptoms that may occur after a zoledronic acid injection are serious and require immediate medical attention. Fever, double vision, confusion, and difficulty speaking or walking may indicate an overdose. Loosening of the teeth, painful or swollen gums, and numbness, tingling, or a heavy feeling in the mouth or jaw could indicate a serious problem. Other severe effects may include swelling of the face or throat, chest pain, irregular heartbeat, breathing difficulty, or the abrupt tightening of muscles. Patients also should contact a medical professional if they experience symptoms that could indicate an allergic reaction such as a rash, hives, or excessive itchiness.

Doctors generally ask about a patient’s medical history before administering a zoledronic acid injection. Patients with low blood-calcium levels are inappropriate candidates for the treatment, as the medication lowers the amount of calcium in the blood. Pregnant and breastfeeding women also should not use the drug. Additionally, patients who have received chemotherapy, radiation, or steroid treatments may have a higher risk of developing bone loss in the jaw, known as osteonecrosis of the jaw, after receiving zoledronic acid injections.

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