| name | Zoledronate |
| Classification | Bisphosphonate, nitrogen-containing |
| Pharmacokinetics | Zoledronate is a potent bisphosphonate that is primarily eliminated via renal excretion. It has a very long half-life, meaning a single dose can provide significant antiresorptive effects for an extended period. Significant bone binding occurs, leading to slow release and long-term efficacy. The drug's duration of action means that it's critical to account for the potential for residual effects. |
| suggested dosage | | adults | | 1 | | indication | Paget's disease | | dosage | 4 mg IV infusion once annually or 4 mg IV infusion every 3-6 months |
| | 2 | | indication | Osteoporosis | | dosage | 5 mg IV infusion once annually |
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| | notes | Dosage and frequency can vary depending on the specific indication. Consult with a healthcare professional for appropriate dosage for individual needs, especially given the patient's age and weight. |
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| indications | | 1 | Paget's disease of bone | | 2 | Osteoporosis | | 3 | Bone metastases from solid tumors |
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| Safety in pregnancy | Zoledronate use during pregnancy is not recommended due to limited data and potential harm to the developing fetus. It's important to discuss alternative treatments with a healthcare provider. |
| Safety in breastfeeding | Zoledronate is present in breast milk. Use is not recommended during breastfeeding due to the potential for adverse effects on the nursing infant. |
| side effects | | 1 | Bone pain | | 2 | Fatigue | | 3 | Headache | | 4 | Myalgia (muscle pain) | | 5 | Arthralgia (joint pain) | | 6 | Fever | | 7 | Nausea | | 8 | Vomiting | | 9 | Constipation | | 10 | Diarrhea | | 11 | Low blood calcium (hypocalcemia) – may be severe and prolonged | | 12 | Renal impairment | | 13 | Serious allergic reactions | | 14 | Jaw osteonecrosis (ONJ) - rare but serious, particularly in patients with dental problems or undergoing dental procedures while receiving Zoledronate treatment |
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| alternatives | |
| contraindications | | 1 | Hypersensitivity to zoledronate or any components of the formulation | | 2 | Severe renal impairment | | 3 | Hypocalcemia | | 4 | Active or recent fractures |
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| interactions | | 1 | Drugs that affect renal function, including diuretics. | | 2 | Concurrent use with certain medications that affect calcium homeostasis. | | 3 | Concurrent use with drugs that alter the metabolism or elimination of Zoledronate. |
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| warnings and precautions | | 1 | Careful monitoring of renal function is critical during therapy. | | 2 | Careful monitoring for hypocalcemia is essential, particularly in the first few weeks of treatment | | 3 | Caution is needed in patients with pre-existing bone disorders | | 4 | Patient should be informed of the potential risk for osteonecrosis of the jaw (ONJ) in patients receiving Zoledronate |
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| additional informations | | 1 | Zoledronate is administered intravenously (IV). | | 2 | It is critical for patients to inform their healthcare provider of all medications they are taking, including supplements and over-the-counter drugs. | | 3 | The long half-life of zoledronate requires careful consideration of drug holidays or discontinuation periods if necessary. |
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