Drug information of Zoledronic acid
Zoledronic acid (sometimes called Zoledronate ) is in a group of medicines called bisphosphonates (bis FOS fo nayts). Zoledronic acid inhibits the release of calcium from bones zoledronic acid used to treat Paget's disease, and to treat or prevent osteoporosis in postmenopausal women or people who take certain steroid medicines. Reclast is also used to increase bone mass in men with osteoporosis.
Mechanism of effect
Zoledronic acid injection is a bisphosphonate and acts primarily on bone. It is an inhibitor of osteoclast-mediated bone resorption.
The selective action of bisphosphonates on bone is based on their high affinity for mineralized bone. Intravenously administered zoledronic acid rapidly partitions to bone and localizes preferentially at sites of high bone turnover. The main molecular target of zoledronic acid in the osteoclast is the enzyme farnesyl pyrophosphate synthase. The relatively long duration of action of zoledronic acid is attributable to its high binding affinity to bone mineral.
Poorly absorbed (oral absorption is about 1% of what intravenous absorption is). Approximately 22% bound in human plasma Zoledronic acid does not inhibit human P450 enzymes in vitro and does not undergo biotransformation in vivo Half life: 146 hours Clearance: Renal
Drug indicationsOsteolytic Bone Metastases of Solid Tumors , Osteolytic Bone Lesions of Multiple Myeloma , Hypercalcemia of Malignancy , Osteoporosis
Treatment of Paget's Disease of Bone The recommended dose is a 5 mg infusion. The infusion time must not be less than 15 minutes given over a constant infusion rate Usual Adult Dose for Osteolytic Bone Lesions of Multiple Myeloma and Osteolytic Bone Metastases of Solid Tumors 4 mg IV over no less than 15 minutes, every 3 to 4 weeks
Side effectsnausea , Headache , constipation , abdominal pain , vomiting , fatigue , rash , Diarrhea , asthenia , Chills , dyspepsia , edema , Peripheral edema , fever , myalgia , Flu-like symptoms , Bone pain , Arthralgia , back pain
InteractionsEsomeprazole , Pantoprazole , Amikacin , Erythromycin , Gentamicin , Furosemide , Calcitonin , Meglumine Compound , Diatrizoate (Amidotrizoic acid) , Ioxaglate , Iothalamate Meglumine
1-Zoledronic acid injection is contraindicated in patients with creatinine clearance less than 35 mL/min 2- Zoledronic acid injection should not be given if the patient is pregnant or plans to become pregnant, or if she is breast-feeding 3- There have been reports of bronchoconstriction in aspirin-sensitive patients receiving bisphosphonates, including zoledronic acid injection. Before being given zoledronic acid injection, patients should tell their doctor if they are aspirin-sensitive 4- If the patient had surgery to remove some or all of the parathyroid glands in their neck, or had sections of their intestine removed, or are unable to take calcium supplements they should tell their doctor
Points of recommendation
1- Before being given zoledronic acid injection, patients should tell their doctor if they have kidney problems and what medications they are taking 2- Zoledronic acid injection is given as an infusion into a vein by a nurse or a doctor, and the infusion time must not be less than 15 minutes. 3- On the day of treatment the patient should eat and drink normally, which includes drinking at least 2 glasses of fluid such as water within a few hours prior to the infusion, as directed by their doctor, before receiving zoledronic acid injection 4- After getting zoledronic acid injection it is strongly recommended patients with Paget's disease take calcium in divided doses (for example, 2 to 4 times a day) for a total of 1500 mg calcium a day to prevent low blood calcium levels. This is especially important for the two weeks after getting zoledronic acid injection