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zoledronate

Bisphosphonate · Antiresorptive agent

BisphosphonateAntiresorptive agent
CDSCO approved
EXCRETION
not curated
INTERACTIONS
none in our sources
PREGNANCY
not curated

Mechanism

Not yet extracted

Indications

Paget diseasetreatment and prevention of osteoporosishypercalcemia of malignancyadjunctive treatment of bone metastases from solid tumorsosteolytic lesions of multiple myelomaHypercalcaemiaBony metastasisOsteolytic lesionsPaget’s diseasePostmenopausal osteoporosis (when oral alendronate/risedronate are not tolerated)For patients whose bone health is compromised by breast cancer therapy (especially estrogen-deprivation agents), as a bone-strengthening agentAssociated with decreased breast cancer recurrence, especially in boneAdministered regularly for metastatic bone disease to reduce skeletal morbidityHumoral Hypercalcemia of MalignancyHypercalcemia in multiple myelomaPrevent bone-related complications in multiple myeloma

Dosing

Adult
For osteoporosis, 5 mg annually intravenously. For hypercalcemia of malignancy, multiple myeloma, or bone metastasis, 4 mg intravenously over at least 15 min. For Paget disease, a single 5-mg intravenous infusion.

Contraindications

  • hypocalcemia
  • creatinine clearance <35 mL/min
  • Gastroesophageal reflux
  • Peptic ulcer
  • Renal impairment (general BPN contraindications)

Side effects

Common
Flu-like symptoms (due to cytokine release)NauseaVomitingBodyacheDizziness
Serious
  • severe hypocalcemia
  • nephrotoxicity
  • deterioration of kidney function
  • osteonecrosis of the jaw
  • fractures of the femoral shaft
  • anaphylaxis
  • Renal toxicity
  • Osteonecrosis of the jaw (rare, with i.v. high dose BPN therapy)
  • Renal dysfunction

Related guidelines

Other Bisphosphonate drugs

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Sources: KD Tripathi 7e, Goodman & Gilman 14e, Harrison 22e·Verified: 2026-05-10 · House clinical team