Zoledronic Acid (Reclast®)

About This Drug

Zoledronic acid is used to treat men and prevent and treat osteoporosis in postmenopausal women. It is also used in the treatment of bone lesions associated with the spread of cancer (bone metastases). It is given in the vein (IV).

Possible Side Effects

  • Fever
  • Headache
  • Eye inflammation
  • Tiredness
  • Nausea and throwing up (vomiting)
  • Loose bowel movements (diarrhea)
  • Bone, joint and muscle pain
  • Pain in your extremities (arm and legs)
  • Flu-like symptoms: fever, headache, muscle and joint aches, and fatigue (low energy, feeling weak)

Note: Each of the side effects above was reported in 10% or greater of patients treated with zoledronic acid. Not all possible side effects are included above.

Warnings and Precautions

  • Changes in your kidney function, which can be life-threatening
  • Osteonecrosis of the jaw. This is a breakdown of the jawbone. It is a serious but rare health problem. Possible symptoms are:
    • Pain, swelling, or infection of the gums
    • Loose teeth
    • Poor healing of the gums
    • Numbness or the feeling that your jaw is heavy
  • Severe joint, bone and muscle pain
  • Risk of hip and femur fractures
  • Risk of bronchospasm and difficulty breathing if you are sensitive to aspirin
  • Severe low calcium, which may cause numbness or tingling around your mouth or in your hands or feet. Other symptoms of low calcium are muscle stiffness, twitching, spasms, or cramps.

Note: Some of the side effects above are very rare. If you have concerns and/or questions, please discuss them with your medical team.

Important Information

  • Do not substitute or take at the same time Zometa®, which is another brand of zoledronic acid.

Treating Side Effects

  • Manage tiredness by pacing your activities for the day.
  • Be sure to include periods of rest between energy-draining activities.
  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • If you throw up, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid).
  • To help with nausea and vomiting, eat small, frequent meals instead of three large meals a day. Choose foods and drinks that are at room temperature. Ask your nurse or doctor about other helpful tips and medicine that is available to help or stop lessen these symptoms.
  • If you have diarrhea, eat low-fiber foods that are high in protein and calories and avoid foods that can irritate your digestive tracts or lead to cramping.
  • Ask your nurse or doctor about medicine that can lessen or stop your diarrhea.
  • Keeping your pain under control is important to your well-being. Please tell your doctor or nurse if you are experiencing pain.
  • Tell your cancer doctor if you have any problems with your teeth or jaw before you start this drug. It is important that your dentist knows that you are on zoledronic acid.

Food and Drug Interactions

  • There are no known interactions of zoledronic acid with food.
  • Check with your doctor or pharmacist about all other prescription medicines and dietary supplements you are taking before starting this medicine as there are known drug interactions with zoledronic acid. Also, check with your doctor or pharmacist before starting any new prescription or over-the-counter medicines, or dietary supplements to make sure that there are no interactions.

When to Call the Doctor

Call your doctor or nurse if you have any of these symptoms and/or any new or unusual symptoms:

  • Fever of 100.5 F (38 C) or higher
  • Chills
  • Headache that does not go away
  • Fatigue that interferes with your daily activities
  • Feeling dizzy or lightheaded
  • Wheezing or trouble breathing
  • Nausea that stops you from eating or drinking and/or is not relieved by prescribed medicines
  • Throwing up more than 3 times a day
  • Loose bowel movements (diarrhea) 4 times a day or loose bowel movements with lack of strength or a feeling of being dizzy
  • Decreased urine, or very dark urine
  • Pain that does not go away, or is not relieved by prescribed medicines
  • New pain in your hip, groin or thigh
  • Signs of osteonecrosis of the jaw such as pain, swelling or infection of the gums, loose teeth, poor healing of the gums, numbness or the feeling that your jaw is heavy
  • Signs of low calcium such as numbness or tingling around your mouth or in your hands and/or feet, muscle stiffness, twitching, spasms, or cramps
  • If you think you may be pregnant

Reproduction Warnings

  • Pregnancy warning: This drug may have harmful effects on the unborn baby. Women of child-bearing potential should use effective methods of birth control during your cancer treatment. Let your doctor know right away if you think you may be pregnant.
  • Breastfeeding warning: It is not known if this drug passes into breast milk. For this reason, Women should not breast feed during treatment because this drug could enter the breast milk and cause harm to a breast feeding baby.
  • Fertility warning: Human fertility studies have not been done with this drug. Talk with your doctor or nurse if you plan to have children. Ask for information on sperm or egg banking.

New February 2018

This information is intended to provide helpful health information to the general public and is not to be used in place of any medical, health, psychological, or any other kind of personal professional services. The information herein does not cover all possible uses, actions, precautions, side effects, or interactions of the medicines mentioned, nor is the information intended as medical advice for individual problems or for making an evaluation as to the risks and benefits of taking a particular medication. The dose, method of administration and contraindications for any administered medication should be confirmed before use. UPMC specifically disclaims all responsibility for any liability, loss or risk, personal or otherwise, which is incurred as a consequence, directly or indirectly, of the use and application of any medication mentioned herein.