Download Zoledronic Acid (ZOE-le-dron-ik AS-id)

Patient Education
Zoledronic Acid (ZOE-le-dron-ik
AS-id)
Other Names
Zometa®, Reclast® (There may be other names for this medication.)
How is it Administered?
This medication is given by infusion into a vein (intravenously). The infusion
is usually given once every 3-4 weeks. Each infusion lasts at least 15
minutes. A few hours before each infusion, drink at least 2 large
glasses of water or other clear liquid.
Why am I Receiving
Zoledronic Acid?
Zoledronic acid stops the breakdown of bone tissue and the release of
calcium caused by tumors. It is not chemotherapy and will not slow or stop
the spread of cancer. It can be used, however, to treat bone disease
caused by multiple myeloma or cancer that has spread to the bone.
How Does it Work?
There are two kinds of bone cells – osteoblasts create bone and osteoclasts
break down bone. Some cancers cause the osteoclasts to speed up their
destruction of bone tissue. This may cause complications such as bone
weakness (raising the risk of bone fracture), pain, and too much calcium in
the blood.
Zoledronic acid is in a class of medications called bisphosphonates. It
works by slowing the osteoclasts’ bone breakdown and preventing or
slowing down the complications of bone destruction listed above.
What Should I Tell My
Doctor Before I Begin
Receiving Zoledronic
Acid?
Tell your doctor if you:
• are allergic to zoledronic acid or similar medicines
• are pregnant or breast feeding
• have ever had low levels of calcium, magnesium, or potassium in your
blood
• have taken zoledronic acid or other bisphosphonates in the past
• have ever had parathyroid or thyroid surgery or surgery to remove parts
of your small intestine
• have anemia, problems with blood clotting; heart failure; difficulties
absorbing nutrients from food; problems with your mouth, teeth, or gums;
an infection; asthma; or parathyroid, kidney, or liver disease
This drug may interact with other medications or cause harmful side
effects. Tell your doctor and pharmacist about all prescription or overthe-counter medications, vitamins, herbal or diet supplements that you
are taking.
What Are Some Possible
Side Effects I May
Experience?
• Fever, usually mild and brief
• Nausea (more common), vomiting (less common)
• Constipation (more common), diarrhea (less common)
•
•
•
•
How Can I Manage
These Side Effects?
Flu-like symptoms: chills, achiness, fatigue
Bone, muscle, or joint pain
Headache
Irritation at the site where you received your infusion
• Ask your doctor about medication to help prevent or less nausea. Eat
small, frequent mails.
• Keep your bowels moving. Drink 2 to 3 quarts of fluid every 24 hours,
unless your doctor told you to restrict your fluid intake. Talk to your
doctor before using any laxative or enema product for constipation.
• Mouth care is very important. Rinse your mouth with a mixture of ½ tsp
of baking soda in 8 ounces of water after every meal and at bedtime.
Brush your teeth and gums often with a soft toothbrush. (Soften it further
by running it under warm water before brushing.)
• Avoid smoking, alcohol, and mouthwashes that contain alcohol.
• Let your doctor/nurse know if you have trouble sleeping or feel anxious.
• Talk to your doctor before taking acetaminophen (Tylenol®) or other
medications for headache or bone, muscle, or joint pain
When Should I Call the
Doctor?
Call your doctor immediately if you experience:
•
signs of infection: fever of 100.5°F (38°C) or higher, chills, cough, sore
throat, pain or burning upon urination; redness or tenderness along a
vein, or at an IV site or wound of any kind
•
signs of hypercalcemia (high calcium): unusual muscle twitching or
spasms, confusion
•
a decrease in how much or how often you urinate
•
severe or sudden leg, hip, or other bone pain
•
signs of allergic reaction (rare): itching, hives, swelling in your face,
hands, mouth, chest tightness, or trouble breathing
Call your doctor as soon as possible if you have:
Dental Health
•
nausea that is not relieved by prescribed medication or that prevents you
from eating or drinking
•
vomiting more than 3 times in 1 day
•
no bowel movement for 3 days or if you feel uncomfortable
•
pain or slow healing in the mouth or jaw
Cancer treatments can affect your teeth and gums and cause:
•
inflammation of the mucous membranes in the mouth (mucositis) and
gum disease
•
infections and sores inside your mouth
•
loss of minerals from your teeth that can cause sensitivity
• taste changes, dry mouth, tooth decay (cavities), difficulty chewing, pain
Your dentist is an important part of your cancer treatment. You should
schedule a dental exam and cleaning before treatment begins and
periodically during the course of your treatment.
PE239
© Roswell Park Cancer Institute
03/2014
It is especially important to practice good dental hygiene.
•
Brush your teeth and tongue after every meal and at bedtime. Use a
soft toothbrush and a gentle stroke.
•
Gently floss once a day to remove plaque. If your gums bleed or hurt,
skip those teeth until bleeding stops.
•
Rinse your mouth with water and avoid mouthwash-containing alcohol.
Osteonecrosis (OSS-tee-oh-ne-KRO-sis) of the jaw is a condition that
involves the loss of bone tissue in the jaw. Though not common, it can be a
serious condition. Symptoms include:
• pain, swelling, infection, or poor healing of the gums
• loosening of teeth
• numbness or the feeling of heaviness in the jaw
Other factors that increase the risk of osteonecrosis include invasive dental
procedures (having a tooth pulled) or dental surgery, infection, gum disease,
radiation therapy to the head or neck, chemotherapy, steroid medications
such as prednisone, anemia and other blood disorders, alcohol abuse,
cigarette smoking, poor nutrition, and a history of poor dental health.
Dental exams should be completed before treatment. If possible, avoid
invasive dental procedures while you are on this medication because
recovery could take longer.
Once your cancer treatment has started, if you experience pain in your
mouth, teeth, or jaw- or any other symptom of possible dental problems- tell
both your oncologist and dentist immediately.
What Else Should I
Know Zoledronic Acid?
• You may have flu-like symptoms during the first few days after your
injection - fever, headache, and bone or muscle pain. These symptoms
may last up to 3-14 days.
• Zoledronic acid may cause severe bone, muscle, or joint pain. You may
begin to feel this pain days, months, or years after your first zoledronic
acid infusion. Call your doctor right away if you experience severe pain
at any time. Your doctor may stop the injections and your pain may go
away.
• Do not get pregnant or father a child while on zoledronic acid. Use a
reliable method of birth control to prevent pregnancy as this medication
may cause harm to a fetus. Call your doctor if you become pregnant or if
you plan to become pregnant in the future. Zoledronic acid may remain
in your body for years after treatment ends.
• Your doctor may recommend you take a calcium supplement or a
multivitamin with vitamin D, take them exactly as directed.
• If you have any other questions about zoledronic acid, please ask your
doctor.
PE239
© Roswell Park Cancer Institute
03/2014