How it is administered

Zoledronic acid is given as an intravenous (IV) infusion. For multiple myeloma and bone metastases from solid tumors, it is typically administered as a single-use IV infusion over at least 15 minutes, every 3 to 4 weeks. The medication comes in vials or ready-to-use bags that are diluted and infused into a vein. The dose may be adjusted based on kidney function, and it should not be mixed with calcium-containing solutions.

How it works

Zoledronic acid is a type of medication called a bisphosphonate. It works by inhibiting the activity of osteoclasts, which are cells that break down bone tissue. In multiple myeloma and certain cancers, bone can be weakened due to increased activity of these cells, leading to bone pain, fractures, and high calcium levels in the blood.

By blocking osteoclasts, zoledronic acid helps to slow down bone loss and reduce the risk of skeletal-related events such as fractures, spinal cord compression, or the need for radiation or surgery to the bone. It also helps lower high blood calcium levels caused by cancer. This action helps maintain stronger bones and improves quality of life for people with multiple myeloma and cancers that have spread to the bone.

Who Should take it

Zoledronic acid is recommended for patients with multiple myeloma and for those with documented bone metastases from solid tumors, in conjunction with standard cancer treatments. It is also used to treat hypercalcemia (high calcium levels) caused by cancer.

For people with multiple myeloma, zoledronic acid can help prevent bone complications, reduce bone pain, and decrease the risk of fractures. It is important that patients have their kidney function checked before starting treatment, as dosing may need to be adjusted based on kidney health.

Who should not take it

Zoledronic acid should not be used by anyone who has had a previous allergic reaction to zoledronic acid or any of its components. It is also not recommended for patients with severe kidney impairment, as the risk of kidney damage is higher. Women who are pregnant or planning to become pregnant should not take zoledronic acid, as it can harm the unborn baby.

Patients with low blood calcium levels (hypocalcemia) should have this corrected before starting zoledronic acid. It is also not indicated for children, and caution is advised in people with liver problems or those taking other drugs that can affect the kidneys.

Commonly used with

Zoledronic acid is often used together with standard antineoplastic (anti-cancer) therapies for multiple myeloma and other cancers. Patients are usually advised to take oral calcium supplements (500 mg) and a multivitamin containing vitamin D (400 IU) daily to help maintain normal calcium levels.

It may also be used alongside pain medications and other supportive treatments as part of comprehensive cancer care.

Commonly tested with

Zoledronic acid has been tested in combination with other cancer treatments such as chemotherapy, corticosteroids, and thalidomide. It is important to monitor kidney function and blood calcium levels when used with other medications that may affect the kidneys or calcium balance, such as aminoglycosides, loop diuretics, or nephrotoxic drugs.