Zoledronic Acid, Injection

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KEY POINTS

• This medicine is given by IV to treat hypercalcemia; multiple myeloma; bone metastases; Paget's disease of the bone; or to prevent or treat osteoporosis.
• Keep all appointments for tests to see how this medicine affects you.
• This medicine may cause severe jaw problems, thigh fractures, or other unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: bisphosphonate; antihypercalcemic

Generic and brand names: zoledronic acid, injection; Reclast; Zometa

What is this medicine used for?

This medicine is given by IV infusion (slow drip through a needle into a large vein).

Zometa is used to treat:

• Hypercalcemia (too much calcium in the blood) caused by cancer
• Multiple myeloma (bone cancer)
• Bone metastases (spread of cancer)

Reclast may be used to treat Paget's disease of the bone, or to prevent or treat osteoporosis.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I receive this medicine?

Tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine
• Aspirin-sensitive asthma (This medicine may worsen asthma)
• Dehydration (not enough water in the body)
• Kidney disease
• Low levels of calcium in the blood
• Thyroid or parathyroid problems
• Trouble absorbing minerals in your stomach or intestines (malabsorption syndrome)

Tell your provider the date of your last dental exam and if you are scheduled for dental surgery. You may be at risk of a disease called osteonecrosis of the jaw if you have dental surgery while taking this medicine.

Females of childbearing age: This medicine is not usually given to pregnant women because it can harm the baby. If you are pregnant, tell your healthcare provider. Do not become pregnant during treatment with this medicine. If you become pregnant, contact your healthcare provider right away. Do not breast-feed while you are receiving this medicine.

How do I take it?

These infusions are given by your healthcare provider. The length of treatment with this medicine depends on how you respond to treatment.

Your healthcare provider may want you to take oral calcium and vitamin D while you are receiving this medicine. Do not take these without your healthcare provider's approval. Also talk with your provider about how much water you should drink while taking this medicine.

What should I watch out for?

This medicine may increase your risk for a rare, but severe thigh bone fracture. Contact your healthcare provider right away if you have any new or unusual thigh or hip pain. Talk with your healthcare provider about this.

This medicine may cause kidney problems. You may need blood tests regularly while you are taking this medicine. Keep all appointments for these tests.

This medicine may increase severe muscle, joint, or bone pain or may cause pain more often. The increased pain may be temporary and may stop during treatment. You may have pain when you first start taking this medicine or several months later. If the pain continues or gets worse, contact your healthcare provider.

This medicine may cause a rare, but serious disease called osteonecrosis of the jaw. You may be at an increased risk for this problem if you have any dental problems or dental surgery, have cancer, anemia, or blood clotting problems, or you are receiving chemotherapy or corticosteroids (such as prednisone). The risk also increases the longer you take this medicine. Talk with your healthcare provider about this. You should brush your teeth and clean your mouth properly while taking this medicine. If you have any jaw pain, swelling, numbness, or loose teeth, contact your healthcare provider right away.

If you develop hives, an itchy rash, or peeling skin, stop taking the medicine and contact your provider right away.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you have received this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (Report these to your healthcare provider right away.): Problems urinating; fever; chills; bone pain; muscle or joint pain; lightheadedness; trouble breathing; chest pain; unusual bleeding and bruising; jaw pain; numbness or tingling around the mouth; seizures; muscle spasms; sores in mouth or jaw; vision problems; swelling in the legs; unusual weakness and tiredness; sore or swollen eyes.

Other: Nausea; vomiting; diarrhea; loss of appetite; trouble sleeping; dizziness; headache; nervousness; depression; redness, swelling, rash, or itching at the spot where you had the infusion.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• Antibiotics such as amikacin, gentamicin, paromomycin, and tobramycin
• Calcitonin (Fortical, Miacalcin)
• Digoxin (Lanoxin)
• Diuretics (water pills) such as bumetanide, ethacrynic acid (Edecrin), furosemide (Lasix), and torsemide (Demadex)
• Medicines to block or prevent stomach acid such as cimetidine (Tagamet), esomeprazole (Nexium), famotidine (Pepcid), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), and ranitidine (Zantac)
• Nonsteroidal anti-inflammatory medicines (NSAIDs) such as diclofenac (Cambia, Voltaren, Zipsor), ibuprofen (Advil, Motrin), indomethacin (Indocin), ketoprofen, ketorolac, nabumetone (Relafen), naproxen (Aleve, Anaprox, Naprelan), oxaprozin (Daypro), piroxicam (Feldene), and sulindac (Clinoril)

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.