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Drug Formulary
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zoledronic acid

( ZOE-le-dron-ik AS-id )
Other Name(s): Zometa®
Appearance: Colourless solution mixed into larger bags of fluids
pdf download zoledronic acid patient.pdf
pdf download acide zoldronique pour le patient.pdf

Medication Information Sheet
zoledronic acid (ZOE-le-dron-ik AS-id)
This document provides general information about your medication. It does not replace the advice of your health care professional. Always discuss your therapy with your health care professional and refer to the package insert for more details.

Other Name: Zometa®

Appearance:
Colourless solution mixed into larger bags of fluids

What is this medication for?

  • Zoledronic acid may:

    • help relieve bone pain and prevent broken bones in some cancers,

    • treat too much calcium in the blood caused by certain types of cancer, or

    • be used as part of anticancer treatment to prevent breast cancer from coming back.

 
What should I do before I have this medication?
  • Tell your health care team if you have or had significant medical condition(s), especially if you have / had:
    • kidney, heart or dental problems,
    • asthma plus an allergy to aspirin (ASA),
    • take other medications for bone problems,
    • have any other allergies,
    • have sores in your mouth, 
    • or if you have any planned dental work.
       
  • Tell your dentist that you are on zoledronic acid.


Remember to:

  • Tell your health care team about all of the other medications you are taking.
     
  • Keep taking other medications that have been prescribed for you, unless you have been told not to by your health care team.
How will this medication affect sex, pregnancy and breastfeeding?
  • The use of this medication in men or women may cause harm to the unborn baby if pregnancy occurs. Let your health care team know if you or your partner is pregnant, becomes pregnant during treatment, or if you are breastfeeding.
     
  • If there is ANY chance that you or your partner may become pregnant, you and your partner together must: 
    • ► Use 2 effective forms of birth control at the same time while taking this drug. Keep using birth control until 6 months after the last dose (general recommendation). Discuss with your healthcare team.
       
  • Do not breastfeed while on this treatment.
     
  • It is not known if this medication affects fertility (ability to get pregnant).
How is this medication given?
  • Zoledronic acid is given by injection into the vein over 15 minutes.

What else do I need to know while on this medication?

Will this medication interact with other medications or natural health products?

  • This medication can interact with other medications, vitamins, foods and natural health products. Interactions can make the treatment not work as well or cause severe side effects.

  • Tell your health care team about all of your:

    • prescription and over-the-counter (non-prescription) medications and all other drugs, such as cannabis/marijuana (medical or recreational)

    • natural health products such as vitamins, herbal teas, homeopathic medicines, and other supplements

  • Check with your health care team before starting or stopping any of them.
     

  • To prevent lowering of your calcium level while using zoledronic acid, your health care team may tell you to take calcium and vitamin D supplements. Do not take calcium or vitamin D if you have/had high calcium levels in the blood. Talk to your health care team before taking these supplements.

 


What to DO while on this medication:

Rarely, some people may have jaw, teeth or mouth problems while using zoledronic acid.

  • DO look for teeth, mouth or jaw problems. You may have pain and swelling, poor healing of mouth sores, unusual discharge from gums, loosening of teeth, and the feeling of numbness or heaviness in the jaw. 
     

  • DO contact your health care team as soon as possible if you get any of these symptoms.
     

  • DO check with your health care team before getting any dental procedures.
     

  • DO maintain good dental hygiene and have regular checkups with your dentist, to prevent jaw problems. 
     

What are the side effects of this medication?

The following side effects have been seen in people using zoledronic acid with other chemotherapy drugs, so some of these effects may be caused by chemotherapy.

You may not have all of the side effects below. You may have side effects that are not listed.

 

Side effects and what to do When to contact doctor?
Common Side Effects (25 to 49 out of 100 people)

Nausea and vomiting

(Usually mild)

May occur in hours to days after your treatment. 
 

If you have nausea or vomiting:

  • Take anti-nausea medication(s) as prescribed to you by your doctor. 
  • Drink clear liquids and have small meals. Get fresh air and rest.
  • Do not eat spicy, fried foods or foods with a strong smell.
  • Limit caffeine (e.g. coffee, tea) and alcohol.
  • Contact your health care team if the prescribed anti-nausea medications are not helping to control your nausea and vomiting.

 Also see Nausea & Vomiting pamphlet for more information.
 

 Contact your health care team if no improvement or if severe

Fatigue (tiredness)

  • Be active and aim to get 30 minutes of moderate exercise (you are able to talk comfortably while exercising) on most days.
  • Check with your health care team before starting any new exercise.
  • Pace yourself, do not rush. Put off less important activities. Rest when you need to.
  • Eat well and stay hydrated by drinking at least 6 to 8 glasses of water or other liquids every day (unless your doctor told you to drink more or less).
  • Avoid driving or using machinery if you are feeling tired

See our Fatigue pamphlet for more information. 

 Contact your health care team if no improvement or if severe

Cough; Feeling short of breath

(May be severe)

You may have cough and feel short of breath without any signs of infection, such as a sore throat or a stuffed nose.

If you have severe chest pain, shortness of breath or are coughing up blood you should seek emergency medical help straight away.

 Contact your health care team if no improvement or if severe

 

Side effects and what to do When to contact doctor?
Less Common Side Effects (10 to 24 out of 100 people)

Diarrhea

May happen days to weeks after you get your treatment.

To help prevent diarrhea :

  • Drink lots of clear liquids. Drink small amounts at a time.
  • Avoid foods or drinks with artificial sweetener (e.g. chewing gum, “diet” drinks), coffee and alcohol.
  • Eat many small meals and snacks instead of 2 or 3 large meals.

If you have diarrhea:

  • Take anti-diarrhea medication if your health care team prescribed it.

​See the Diarrhea pamphlet for more information.

 Contact your health care team if no improvement or if severe

Headache; mild joint, muscle pain

(May be severe)

  • Take your pain medication as prescribed by your doctor.
  • You can take acetaminophen (Tylenol®) tablets as needed for mild aches and pains. Ask your doctor or pharmacist about the right dose for you.
  • Talk to your doctor or pharmacist first before taking ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or aspirin. These medication may increase bleeding risk.
  • Rest often and try light exercise as it may help.
 Contact your health care team if no improvement or if severe

Mild swelling in arms and legs; puffiness

To help prevent swelling :

  • Eat a low-salt diet.
  • Avoid tight fitting clothing.

If you have swelling in your legs, keep your feet up when sitting.

 Contact your health care team if no improvement or if severe

Dizziness

  • You may feel light headed.
  • Lay down if this happens.
  • Get up and move slowly once you feel better.
  • Do not drive a motor vehicle or use machinery if you feel dizzy.
 Contact your health care team if no improvement or if severe

Kidney problems

(May be severe)

  • You may have lower back pain, swelling, pee less than usual and have unusual weight gain.
  • Your doctor may monitor for proteins in your pee. You may have blood in your pee.
  • This may be sign of a serious kidney or bladder infection.
  • In rare cases, you may pee more than usual and lose protein, sugar and other substances in your pee. You may feel weak and/or have bone pain. See your doctor right away. 

To prevent bladder or kidney problems, drink lots of water or other liquids. Drink at least 6 to 8 cups (2 L) of liquids per day on treatment days, unless you have been told otherwise.  

 Get emergency medical help right away

Weight Loss, Low appetite

  • You may not feel like eating or you may lose weight.
  • Try to eat foods that you like and eat small meals throughout the day. 
  • You may need to take meal supplements to help keep your weight up.
  • Talk to your health care team if you have a low appetite.
  • See our Loss of appetite pamphlet for more information.
 Contact your health care team if no improvement or if severe

Tingling, numb fingers and toes

  • May slowly get better after your treatment ends.
  • Contact your health care team if you have trouble doing up buttons, writing, picking up small objects, have pain or trouble moving.

 

 Contact your health care team if no improvement or if severe

Depression

Everyone feels sad sometimes and having cancer can cause you to feel down. Depression is when these feelings last for weeks or months.

To help prevent depression : 

  • Eating well and exercising may give you more energy and help you feel better.  Always check with your health care team before starting a new exercise program to make sure it is safe for you.
  • Get support from your family, friends, community and health care team.
 Contact your health care team if no improvement or if severe

Salt imbalances

It may cause muscle twitching, severe weakness or cramping, confusion and irregular heartbeat.

 Get emergency medical help right away

Flu-like symptoms

  • You may have fever, chills and muscle pain without any signs of infection, such as a sore throat, cough or skin rash.
  • It may happen at any time after you receive your treatment and it usually goes away as your body gets used to the medication.
  • Contact your health care team if these feelings bother you.
  • Check your temperature to make sure you don’t have a fever. If you do not have a fever, you may take acetaminophen (Tylenol®) tablets to help you feel better.  Ask your health care team for the correct dose for you. If you do have a fever, speak to your health care team or go to the nearest emergency room. 
 Contact your health care team if no improvement or if severe

Other rare, but serious side effects are possible.
If you experience ANY of the following, speak to your cancer health care provider or get emergency medical help right away:

  • severe bone pain

  • irregular heartbeat or low blood pressure

  • blurred vision or changes to your vision

  • signs of an allergic reaction:  fever, itchiness, rash, swollen lips, face or tongue, chest and throat tightness

 

Who do I contact if I have questions or need help?          

My cancer health care provider is: ______________________________________________

During the day I should contact:________________________________________________

Evenings, weekends and holidays:______________________________________________

 

Other Notes:

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________


December 2023 Updated information sheet

For more links on how to manage your symptoms go to www.cancercareontario.ca/symptoms.

The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.

A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.

Funding & Reimbursement

Several payment sources exist for cancer drugs in Ontario, depending on the drug, disease indication, and how and where it is delivered.

View Funding & Reimbursement

Symptom Management

Many people living with cancer experience nausea, diarrhea and other symptoms from their treatment or disease.

View Symptom Management

Drug Safety and Administration

Find documents on drug safety and administration for healthcare providers, including calculations and recommendations.

View Drug Safety and Administration