Zoledronic Acid (Generic Name)

Other Names: Zometa®

About This Drug

Zoledronic acid is used to treat high levels of blood calcium (hypercalcemia), which affects patients with certain types of cancer. It also is used to treat multiple myeloma (tumors formed by bone marrow cells) and/or bone lesions associated with the spread of cancer (bone metastases).  This drug is given intravenously (IV).

Possible Side Effects (More Common)

  • Fever
  • Back and joint pain
  • Nausea and vomiting
  • Lower belly pain
  • Changes in kidney function. This drug may affect how your kidneys work. Your kidney function will be checked as needed.
  • Changes in bowel movements. Some patients experience diarrhea, while others experience constipation.
  • Trouble breathing
  • Dizziness or lightheadedness
  • White spots on your lips, tongue, or inside your mouth
  • Nervousness
  • Trouble sleeping
  • Confusion
  • Cough
  • Anemia. You may feel very tired.
  • Changes in your electrolytes. Your doctor will monitor your blood for changes as needed.
  • Swelling of hands, feet, or legs
  • Tiredness
  • Usually hair loss is temporary.  Your hair should grow back when treatment is completed.

Possible Side Effects (Less Common)

  • Osteonecrosis (oss-tee-oh-ne-KRO-sis) of the jaw. This is a breakdown of the jaw bone. It is a serious but rare condition. Possible symptoms include:
    • Pain, swelling, or infection of the gums
    • Loosening of the teeth
    • Poor healing of the gums
    • Numbness or the feeling of heaviness in the jaw

Sexual Problems and Reproductive Concerns

Pregnancy warning: This drug may have harmful effects on the unborn child, so effective methods of birth control should be used during your cancer treatment.  Ask your doctor or nurse about effective methods of birth control.

Genetic counseling is available to you to discuss the effects of this drug therapy on future pregnancies. In addition, a genetic counselor can review the potential risks of problems in the fetus due to this medication if an exposure during pregnancy has occurred.

Breast feeding warning: Women are advised not to breast feed during treatment because this drug could enter the breast milk and seriously harm a breast feeding infant.

Treating Side Effects

  • Drink 6-8 cups of fluids every day unless your doctor has told you to restrict your fluid intake due to another medical condition. A cup is 8 ounces of fluid. If you vomit or have diarrhea, you should drink more fluids so that you do not become dehydrated.
  • If you are constipated, ask your doctor or nurse for medicines and diet changes that may help you move your bowels regularly.
  • Ask your doctor or nurse about medicine to help prevent or lessen nausea, vomiting, diarrhea, and/or back and joint pain.
  • Let your doctor or nurse know if you are having trouble sleeping or if you feel very nervous.
  • Tell your oncologist if you have dental problems before you start this drug. It is important that your dentist knows that you are on this drug. Provide your dentist and your oncologist with each other’s name and telephone number for consultation.
  • Mouth care is very important. Your mouth care should consist of regular, gentle cleaning of your teeth or dentures and rinsing your mouth with a mixture of 1/2 teaspoon of salt in 8 ounces of water or ½ teaspoon of sodium bicarbonate (baking soda) in 8 ounces of water. This should be done at least after every meal and at bedtime.
  • Use a mirror to check your teeth and gums daily for any changes, such as sores or bleeding gums. If you notice a change, report it to your oncologist immediately.
  • If you have mouth sores, avoid mouthwash that contains alcohol. Avoid alcohol and smoking because they can irritate your mouth and throat.

Important Instructions

It is very important you discuss dental work with your oncologist before you have it done. This includes pulling of teeth, insertion of dental implants, and special gum treatments.

Food and Drug Interactions

There are no known interactions of zoledronic acid with food. This drug may interact with other medicine. Tell your doctor and pharmacist about all the medicines and dietary supplements (vitamins, minerals, herbs, and others) that you are currently taking. The safety and effectiveness of dietary supplements and alternative diets are often unknown. Using these might unexpectedly affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor’s advice.

When to Call the Doctor

Call your doctor or nurse immediately if you have any of the following symptoms:

  • Temperature of 100.5 F (38 C) or above
  • Chills
  • Uncontrolled nausea that prevents you from eating or drinking
  • Vomiting more than 3 times in 1 day
  • Dizziness or lightheadedness
  • Shortness of breath
  • Rash or itching
  • Chest pain or symptoms of a heart attack. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes. Or the discomfort may go away and come back. It can feel like uncomfortable pressure, squeezing, fullness, or pain. Sometimes discomfort is felt in one or both arms, the back, neck, jaw, or stomach. If any of these symptoms last 2 minutes, call 911.
  • Confusion

Call your doctor or nurse as soon as possible if you have any of the following symptoms:

  • Lower belly pain or nausea that prescribed medicine doesn’t help
  • No bowel movement for 3 days or if you feel uncomfortable
  • White spots on your lips, tongue, or inside your mouth
  • Diarrhea of 5 or 6 stools in 1 day or diarrhea with weakness
  • Headache that prescribed medicine doesn’t help
  • Cough that is bothersome
  • Pain in your mouth, teeth, gums or jaw
  • Swelling or bleeding of your gums
  • Loosening of your teeth
  • Numbness or the feeling of heaviness in the jaw

Revised January 2012

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