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Zoledronic Acid (Reclast, Zometa)

Warning: Zoledronic acid (Reclast) should be not recommended to patients with significant kidney disease (renal impairment). Therefore, physicians should screen patients for kidney dysfunction before prescribing the medication to a patient according to the FDA. This decision has been taken by the agency after receiving 20 reports of acute kidney failure resulting in death or requiring dialysis.

Indications: This medication is used to treat high blood calcium in patients with cancer (also known as hypercalcemia). It is also used with chemotherapy drugs to treat bone problems that may occur with multiple myeloma and other cancers that have spread to the bones. This includes breast and lung cancer. This medication works by lowering high blood calcium levels by reducing the amount of calcium released from your bones into your blood. It can also help prevent bone fractures for patients who have had cancer and their bone density has been compromised.

Dosage: Zoledronic is given intravenously by a health care professional for over a period of 15 minutes. The exact dosage is determined by your doctor based on your medical condition and kidney function. The doctor will periodically check your blood calcium levels to determine if the dosage should be adjusted. Prior to receiving this medication, you may be given fluids to help decrease the chance of kidney problems. Make sure to drink plenty of fluids during and after treatment unless your doctor tells you otherwise.  

If you are receiving this medication for the treatment of multiple myeloma or bone problems caused by cancer, you will usually be given the drug every 3 to 4 weeks or as often as directed by your doctor.

 

Overdose: zoledronic acid must be given exactly as directed by a health professional that has experience in chemotherapy drugs. In fact, not only zoledronic acid, but taking any medication in the right dose is the first step to better treatment. An overdose of zoledronic acid may cause serious kidney problems. Contact your doctor immediately if you experience these warning signs of overdose:  

  • seizures 
  • confusion 
  • double vision 
  • shortness of breath 
  • sudden tightening of muscles 
  • muscle cramps or/and weakness 
  • fast, pounding, or irregular heartbeat 
  • difficulty walking or/and speaking  
  • Numbness, burning, or tingling in fingers or toes.  

Interactions: Taking certain medications while using Zoledronic may affect how the medication works or cause serious side effects. If you are being treated with other medications to prevent or treat bone loss or osteoporosis, tell your doctor. This medication should not be taken with any bisphosphonates. Also tell your doctor about what other prescriptions you are taking so they can check for possible interactions with this medication. Make sure to your doctor and pharmacist everything you are taking including non prescription medicines and herbal medicines. Do not start or stop any medications without talking to your doctor first.

 

Contraindications: Tell your doctor or pharmacist if you are allergic to medications or if you have other allergies. Your doctor will need a medical history from you especially if you have had kidney problems or dehydration. This medication may increase the risk for serious jawbone problems so tell your doctor if you start to experience jaw pain. Tell your doctor or dentist if you plan to have any surgeries while taking Zoledronic or any other type of prescription and non prescription drugs. This medication could be potentially harmful to an unborn baby so talk to your doctor if you are pregnant or plan to become pregnant. It may be necessary to discuss reliable forms of birth control. It is not know if this medication is passed through breast milk. Talk to your doctor if you are breastfeeding.

 

Side effects: In addition to attacking cancer cells, zoledronic acid also affects some normal cells and cause adverse effects in most patients. Most common zoledronic acid side effects include  

  • intense thirst
  • diarrhea
  • bone or joint pain
  • swollen legs
  • fatigue
  • white vaginal discharge
  • hair loss
  • heartburn
  • fever
  • headaches
  • loss of appetite
  • loss of weight
  • nausea and vomiting
  • difficulty falling asleep or staying asleep
  • white patches in the mouth
  • redness of the eye or excessive tearing
  • redness or swelling at the injection site
  • Numbness, burning, or tingling in fingers or toes

If the side effects above persist for weeks, contact your oncologist. In addition, contact your doctor if you experience any of these symptoms: 

  • chest pain  
  • painful or swollen gums 
  • Poor healing of the gums
  • loosening of the teeth 
  • irregular heartbeat 
  • numbness or the feeling of heaviness in the jaw 
  • signs of infections: rash, hives, itching, fever, sore throat  
  • swelling of the eyes, face, lips, tongue and/or throat 
  • swelling of the hands, arms, feet, ankles, and/or lower legs
  • difficulty breathing or swallowing 
  • numbness or tingling around the mouth 
  • sudden tightening of muscles 
  • Unusual bruising or bleeding.  

 

References: 

http://www.pharma.us.novartis.com/product/pi/pdf/Zometa.pdf 

http://www.us.zometa.com/info/cancer_bones/dental_health.jsp