Zoledronic acid Intravenous

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For zoledronic acid, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to zoledronic acid or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Zoledronic acid injection is not indicated for use in children.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of zoledronic acid injection in the elderly. However, elderly patients are more likely to have age-related kidney problems, which may require caution in patients receiving zoledronic acid injection.

Pregnancy

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of zoledronic acid. Make sure you tell your doctor if you have any other medical problems, especially:

• Anemia or
• Bleeding problems or
• Cancer, history of or
• Dental or tooth problems or
• Dental procedures or
• Poor oral hygiene, or
• Surgery (eg, dental surgery)—May increase risk for severe jaw problems.

• Asthma, aspirin-sensitive or
• Heart disease or
• Kidney disease or
• Mineral imbalance (eg, high or low calcium, magnesium, phosphorus, or potassium in the blood)—Use with caution. May make these conditions worse.

• Bowel resection or
• Parathyroid disease (eg, hypoparathyroidism) or
• Parathyroid surgery or
• Stomach absorption problems or
• Thyroid surgery—These conditions may increase your risk of having hypocalcemia (low levels of calcium in the blood).

• Dehydration (not enough water or fluid in your body)—May increase risk of severe kidney problems.

• Hypocalcemia (low calcium in the blood) or
• Kidney disease, severe (eg, kidney failure)—Should not be used in patients with these conditions.

A nurse or other trained health professional will give you zoledronic acid. zoledronic acid is given through a needle placed in one of your veins. The medicine must be injected slowly, so your IV tube will need to stay in place for at least 15 minutes.

For hypercalcemia, zoledronic acid is usually given only once. If your doctor decides that you need additional doses, you will receive the medicine again after at least 7 days have passed. This treatment will continue until your body responds to the medicine.

For bone cancer and multiple myeloma, zoledronic acid is usually given every 3 to 4 weeks. This treatment will continue until your body responds to the medicine.

For osteoporosis, zoledronic acid is usually given once a year and will continue until your body responds to the medicine.

You may also receive other medicines to help keep your body from losing too much fluid.

Your doctor may also give you vitamins containing Vitamin D and calcium. Tell your doctor if you are unable to take these supplements.

Drink extra fluids so you will pass more urine while you are using zoledronic acid. This will keep your kidneys working well and help prevent kidney problems. However, it is very important to not drink too much liquid. Talk to your doctor about the right amount of liquids for you.

zoledronic acid comes with a Medication Guide. It is very important that you read and understand this information. Be sure to ask your doctor about anything you do not understand.

This medication is used to treat high blood calcium levels (hypercalcemia) that may occur with cancer. Zoledronic acid is also used with cancer chemotherapy to treat bone problems that may occur with multiple myeloma and other types of cancer (such as breast, lung) that have spread to the bones. Zoledronic acid belongs to a class of drugs known as bisphosphonates. It lowers high blood calcium levels by reducing the amount of calcium released from your bones into your blood. It also works by slowing the breakdown of your bones by cancer to prevent bone fractures.

How to use Zoledronic Acid Vial

Read the Patient Information Leaflet if available from your pharmacist before you start receiving zoledronic acid and each time you get a treatment. If you have any questions, ask your doctor or pharmacist.

This medication is given by injection into a vein as directed by your doctor, usually over at least 15 minutes. The dosage is based on your medical condition (including your kidney function) and response to treatment.

If you are giving this medication to yourself at home, learn all preparation and usage instructions from your health care professional. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Learn how to store and discard medical supplies safely.

Avoid mixing zoledronic acid with IV fluids that have calcium in them (such as Ringer's solution, Hartmann's solution, parenteral nutrition-TPN/PPN). Talk to your pharmacist for more details.

For the treatment of high blood calcium levels, fluids are usually given through a vein before you receive this medication. To decrease the chance of kidney problems, drink plenty of fluids during treatment unless otherwise directed by your doctor. It takes at least 7 days after a dose to get the full benefit of this drug. The dose may need to be repeated depending on your blood calcium levels.

For the treatment of multiple myeloma and bone problems caused by the spread of cancer, this medication is usually given every 3 to 4 weeks or as directed by your doctor. You may also be instructed to take calcium and vitamin D supplements each day.

Before using zoledronic acid, tell your doctor or pharmacist if you are allergic to it; or to other bisphosphonates (such as alendronate, risedronate); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney problems, loss of too much body water (dehydration), aspirin-sensitive asthma.

Some people using zoledronic acid may have serious jawbone problems. Your doctor should check your mouth before you start this medication. Tell your dentist that you are using this medication before you have any dental work done. To help prevent jawbone problems, have regular dental exams and learn how to keep your teeth and gums healthy. If you have jaw pain, tell your doctor and dentist right away.

Before having any surgery (especially dental procedures), tell your doctor and dentist about this medication and all other products you use (including prescription drugs, nonprescription drugs, and herbal products).

This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.

This medication may cause severe kidney problems, especially in the elderly. Consult your doctor or pharmacist for more information. To help prevent harm to your kidneys, drink plenty of fluids unless otherwise directed by your doctor. (See also How to Use section.)

This medication is not recommended for use during pregnancy. It may harm an unborn baby. Consult your doctor for more details.

It is unknown if this drug passes into breast milk. Because it may harm a nursing infant, breast-feeding while using this drug is not recommended. Consult your doctor before breast-feeding.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

While using this medication, you should not be treated with other bisphosphonates, including other brands of zoledronic acid used to prevent or treat bone loss (osteoporosis).

Some products that may interact with this drug include: calcium-containing IV fluids, "water pills" (diuretics such as bumetanide, furosemide).

Also tell your doctor or pharmacist of drugs that may be harmful to your kidneys such as: aminoglycoside antibiotics (e.g., gentamicin, tobramycin), amphotericin B, nonsteroidal anti-inflammatory drugs (NSAIDs such as ibuprofen), tacrolimus.