From the Guidelines
Zometa (Zoledronic acid) is a bisphosphonate used to prevent or delay disease-associated skeletal-related events (SREs) in patients with cancer, particularly those with bone metastases.
Key Points
- Zoledronic acid is administered intravenously, typically every 3-4 weeks, to reduce the risk of SREs such as pathologic fractures, spinal cord compression, and the need for radiation or surgery to bone 1.
- The optimal duration of zoledronic acid treatment is unclear, but it is recommended to continue treatment until there is a substantial decline in the patient's performance status or until the underlying bone disease is well controlled by antineoplastic treatment 1.
- Zoledronic acid has been shown to be effective in reducing SREs and improving quality of life in patients with breast cancer and multiple myeloma, as well as prostate cancer 1.
- The medication can cause adverse effects such as hypocalcemia, arthralgias, and osteonecrosis of the jaw (ONJ), and patients should undergo dental examination and receive preventive dental care before starting treatment 1.
- Zoledronic acid should be dose-reduced in patients with impaired renal function and held for creatinine clearance <30 mL/min 1.
Dosage and Administration
- The recommended dose of zoledronic acid is 4 mg administered intravenously every 3-4 weeks 1.
- The infusion time for zoledronic acid should be at least 15 minutes to reduce the risk of renal toxicity 1.
Special Considerations
- Patients with preexisting dental problems are at higher risk for ONJ and should receive preventive dental care before starting zoledronic acid treatment 1.
- Zoledronic acid should be used with caution in patients with impaired renal function, and serum creatinine should be monitored before each dose 1.
From the FDA Drug Label
Zoledronic acid injection contains zoledronic acid, a bisphosphonic acid which is an inhibitor of osteoclastic bone resorption. Zoledronic acid is designated chemically as (1-Hydroxy-2-imidazol-1-yl-phosphonoethyl) phosphonic acid monohydrate and its structural formula is: Zoledronic acid is a white crystalline powder.
Zometa (Zoledronic acid) is a bisphosphonic acid that acts as an inhibitor of osteoclastic bone resorption. It is used to treat various conditions, including hypercalcemia of malignancy and bone metastases. The drug is administered via intravenous infusion and is available in 5 mL vials as a sterile liquid solution for dilution prior to infusion 2, 2, 2.
- Key characteristics:
- Chemical designation: (1-Hydroxy-2-imidazol-1-yl-phosphonoethyl) phosphonic acid monohydrate
- Molecular formula: C5H10N2O7P2 • H2O
- Molar mass: 290.1 g/mol
- Solubility: Highly soluble in 0.1N sodium hydroxide solution, sparingly soluble in water and 0.1N hydrochloric acid, and practically insoluble in organic solvents.
From the Research
Definition and Mechanism of Zometa (Zoledronic acid)
- Zometa (Zoledronic acid) is a nitrogen-containing bisphosphonate that rapidly binds to bone mineral and inhibits the mevalonate pathway, stopping osteoclast function and slowing bone resorption 3.
- It is an effective inhibitor of osteoclast-mediated bone resorption 4.
Clinical Uses of Zometa (Zoledronic acid)
- Zometa is approved for the prevention of skeletal morbidity in metastatic bone disease from solid tumors and multiple myeloma 3.
- It is also recommended as an option for the treatment of cancer therapy-induced bone loss 3.
- Zometa has been shown to be effective in reducing skeletal-related events (SREs) in patients with multiple myeloma or bone metastases secondary to breast cancer, prostate cancer, or other solid tumors 4, 5, 6, 7.
- It has also been shown to be effective in the treatment of hypercalcaemia of malignancy 4, 5.
Efficacy and Safety of Zometa (Zoledronic acid)
- Zometa has been shown to be superior to pamidronic acid in reducing the risk of SREs in patients with breast cancer and multiple myeloma 4, 5, 7.
- It has also been shown to be effective in reducing the risk of SREs in patients with prostate cancer and other solid tumors 4, 5, 7.
- Zometa is generally well tolerated, with a tolerability profile similar to that of pamidronic acid and placebo 4, 5, 7.
- The most commonly reported adverse events include flu-like symptoms, fatigue, gastrointestinal reactions, anaemia, weakness, dyspnoea, and oedema 4.