Zoledronic Acid Injection (Paget's Disease, Osteoporosis)

What is this medication?

ZOLEDRONIC ACID (ZOE le dron ik AS id) slows calcium loss from bones. It treats Paget's disease and osteoporosis. It may be used in other people at risk for bone loss.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Reclast, Zometa, Zometa Powder

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

• bleeding disorder
• cancer
• dental disease
• kidney disease
• low levels of calcium in the blood
• low red blood cell counts
• lung or breathing disease (asthma)
• receiving steroids like dexamethasone or prednisone
• an unusual or allergic reaction to zoledronic acid, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I use this medication?

This drug is injected into a vein. It is given by a health care provider in a hospital or clinic setting.

A special MedGuide will be given to you before each treatment. Be sure to read this information carefully each time.

Talk to your health care provider about the use of this drug in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

Keep appointments for follow-up doses. It is important not to miss your dose. Call your health care provider if you are unable to keep an appointment.

What may interact with this medication?

• certain antibiotics given by injection
• NSAIDs, medicines for pain and inflammation, like ibuprofen or naproxen
• some diuretics like bumetanide, furosemide
• teriparatide

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Visit your health care provider for regular checks on your progress. It may be some time before you see the benefit from this drug.

Some people who take this drug have severe bone, joint, or muscle pain. This drug may also increase your risk for jaw problems or a broken thigh bone. Tell your health care provider right away if you have severe pain in your jaw, bones, joints, or muscles. Tell you health care provider if you have any pain that does not go away or that gets worse.

You should make sure you get enough calcium and vitamin D while you are taking this drug. Discuss the foods you eat and the vitamins you take with your health care provider.

You may need blood work done while you are taking this drug.

Tell your dentist and dental surgeon that you are taking this drug. You should not have major dental surgery while on this drug. See your dentist to have a dental exam and fix any dental problems before starting this drug. Take good care of your teeth while on this drug. Make sure you see your dentist for regular follow-up appointments.

What side effects may I notice from receiving this medication?

Side effects that you should report to your doctor or health care provider as soon as possible:

• allergic reactions (skin rash, itching or hives; swelling of the face, lips, or tongue)
• bone pain
• infection (fever, chills, cough, sore throat, pain or trouble passing urine)
• jaw pain, especially after dental work
• joint pain
• kidney injury (trouble passing urine or change in the amount of urine)
• low calcium levels (fast heartbeat; muscle cramps or pain; pain, tingling, or numbness in the hands or feet; seizures)
• low red blood cell counts (trouble breathing; feeling faint; lightheaded, falls; unusually weak or tired)
• muscle pain
• palpitations
• redness, blistering, peeling, or loosening of the skin, including inside the mouth

Side effects that usually do not require medical attention (report to your doctor or health care provider if they continue or are bothersome):

• diarrhea
• eye irritation, itching, or pain
• fever
• general ill feeling or flu-like symptoms
• headache
• increase in blood pressure
• nausea
• pain, redness, or irritation at site where injected
• stomach pain
• upset stomach

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

This drug is given in a hospital or clinic. It will not be stored at home.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.