Introduction
Zoltero is used to treat or prevent weakening of the bones (osteoporosis) caused by menopause or use of steroids. Using this medicine can reduce your risk of breaking bones. It is also used to treat high levels of calcium in people who have cancer.
Zoltero is given by a doctor or nurse. How much you are given, and how often, will be decided by your doctor. It may just be a single injection or you may need regular injections depending upon your underlying condition. Your doctor will ask you to drink plenty of water before the injection, to avoid getting dehydrated. It may take several days to get the full benefit of this drug. Zoltero is only part of a treatment program that may also include changes to your diet and taking calcium and vitamin supplements.
The most common side effects include headache, flu-like symptoms, muscle pain and nausea. These are usually mild and will disappear after a short time. If they do not go away, tell your doctor. Zoltero can cause serious kidney problems, especially if you are dehydrated, if you take diuretic medicine (water pills) or if you already have kidney disease. It can also cause low levels of calcium in the blood and pain in the mouth or jaw. These are serious side effects and need urgent medical attention. Tell your doctor straight away if you notice any of these.
You should not be given this medicine if you are pregnant or breastfeeding. Before taking it, tell your doctor if you have kidney problems or low calcium levels. Also let your doctor know what other medicines you are taking. Some of them may affect, or be affected by, this injection, especially medicines used to treat severe infections and medicines used to treat cancer and osteoporosis. You may need frequent medical tests to check your kidney function and calcium levels. Avoid smoking as it can reduce your bone mineral density, making fractures more likely. Drinking large amounts of alcohol can also cause bone loss and should be avoided.
Uses of Zoltero
- Osteoporosis
- Hypercalcemia
Side effects of Zoltero
Common
- Headache
- Back pain
- Musculoskeletal (bone, muscle or joint) pain
- Heartburn
- Diarrhea
How to use Zoltero
Your doctor or nurse will give you this medicine. Kindly do not self-administer.
How Zoltero works
Zoltero is a bisphosphonate. It works by suppressing the activity of osteoclasts, cells that cause destruction of bone. This strengthens the bones and minimizes the risk of fractures.
What if you forget to take Zoltero?
If you miss a dose of Zoltero. Please consult your doctor.
Indication
Paget's disease of bone, Postmenopausal osteoporosis, Corticosteroid-induced osteoporosis
Administration
Reconstitute powder with 5 mL SWI; once powder is fully dissolved, dilute further in 100 mL NS or D5W before administering
Adult Dose
Paget's disease of bone
Adult: 5 mg as a single infusion over 15 min. Patients should receive elemental Ca 1,500 mg and vit D 800 IU daily particularly w/in 2 wk after admin. Patients who have relapsed: May be given an additional infusion of 5 mg after an interval of at least 1 yr from the initial dose.
Osteoporosis in postmenopausal women; Increase bone mass in men with osteoporosis; Corticosteroid-induced osteoporosis
Adult: 5 mg as a single infusion over at least 15 min, once yrly, w/ adequate Ca and vit D intake. Patients w/ low-trauma hip fracture: Start 2 or more wk after hip fracture repair w/ a loading dose of vit D 50,000-125,000 IU given orally or by IM route prior to 1st infusion.
Prophylaxis of postmenopausal osteoporosis
Adult: 5 mg as a single infusion once every 2 yr.
Hepatic impairment
Safety and efficacy not established
Child Dose
Safety and efficacy not established
Renal Dose
Renal impairment
CrCl >35 mL/min: No adjustment needed
CrCl <35 mL/min: Contraindicated
Contraindication
The drug is contraindicated if patients have hypersensitivity to the active substance or to any of the excipients or to any bisphosphonates, hypocalcaemia, renal impairment (creatinine clearance <35 mL/min), current or recent uveitis, or a history of bisphosphonate-associated uveitis, pregnancy and lactation.
Mode of Action
Zoledronic acid, an aminobiphosphonate, is a potent inhibitor of bone resorption. It inhibits osteoclastic activity and skeletal calcium release caused by tumours.
Precaution
Patient w/ aspirin-sensitive asthma. Mild to moderate renal impairment. Pregnancy. Patient Counselling This drug may cause dizziness, if affected, do not drive or operate machinery. Adequately hydrate patients prior to admin. Ensure adequate Ca and vit D intake. Monitoring Parameters Monitor serum Ca, Mg, phosphate and electrolytes; haematocrit/Hb (oncology use); biochemical markers of bone turnover (non-oncology use). Prior to therapy, perform dental exam and preventive dentistry in patients at risk of osteonecrosis.
Lactation: Unknown whether drug crosses into breast milk; avoid using
Side Effect
Arthralgia, fever, flu-like symptoms, myalgia, headache, pain in extremity, nausea, vomiting, diarrhoea, eye inflammation; alopecia, hyperhidrosis, bone/joint/muscle pain, osteonecrosis of the jaw, femoral fracture, hypersensitivity reactions (e.g. urticaria, angioedema), Stevens-Johnson syndrome, toxic epidermal necrolysis, hypotension.
Potentially Fatal: Severe hypocalcaemia, severe kidney problems.
Interaction
Increased risk of hypocalcaemia with aminoglycosides and loop diuretics. Increased risk renal dysfunction with nephrotoxic agents.