Zoledronate

Administration

  • Type: Bisphosphonate
  • Dosage Forms:
  • Routes of Administration: IV
  • Common Trade Names:

Adult Dosing

  • 4mg IV once, may repeat in 7d

Pediatric Dosing

Safety/efficacy not established

Special Populations

Pregnancy Rating

  • Pregnancy category D

Lactation risk

  • No information available, avoid use or breastfeeding

Renal Dosing

  • Adult:
    • CrCl 50-60 mL/min: 3.5 mg
    • CrCl 40-49 mL/min: 3.3 mg
    • CrCl 30-39 mL/min: 3 mg
    • CrCl <30 mL/min: Not recommended

Hepatic Dosing

Safety/efficacy not established

Contraindications

  • Allergy to class/drug
  • Hypocalcemia
  • Severe renal impairment (CrCl <35 mL/min or evidence of acute renal impairment)
    • Rehydrate hypovolemic patients prior to administration

Adverse Reactions

Serious

  • Hypocalcemia
  • Bronchoconstriction if aspirin-sensitive asthma
  • Osteonecrosis (usually of jaw)
  • Acquired fanconi syndrome
  • Hypotension

Common

  • Bone pain, arthralgia
  • Nausea/vomiting, constipation, diarrhea
  • Fever
  • Fatigue, insomnia, anxiety
  • Anemia
  • Dyspnea
  • Headache, dizziness
  • UTI
  • Hypophosphatemia, hypokalemia, hypomagnesemia
  • Rash

Pharmacology

  • Half-life: 146h
  • Metabolism: Not metabolized
  • Excretion: Urinary

Mechanism of Action

  • Acts on osteoclasts to inhibit bone resorption

Comments

See Also

References

https://reference.medscape.com/drug/reclast-zometa-zoledronic-acid-342858#10

Authors:

Claire